Sudden Rupture of Small Pseudoaneurysm of the Radial Artery in a Patient with COVID-19 Pneumonia

Abstract

We report the case of sudden rupture of a radial artery small Pseudoaneurysm (PSA) occurring in a 63-years-old patient who had been hospitalized for COVID-19 pneumonia. A 63-years-old man was admitted to our hospital for SARS-CoV-2 infection causing progressive respiratory failure that required non-invasive mechanical ventilation. A 4 French catheter was placed in his right radial artery at the level of the wrist for repetitive arterial blood sampling for gas analysis. During the hospitalization, the patient recovered from the respiratory distress and the arterial line was removed, but he developed a focal ectasia of the radial artery (6 mm), which was treated with compression and antibiotics. However, after 2 days, a sudden hemorrhage from the wrist occurred, requiring emergent surgery. Intraoperatively, the radial artery was completely disrupted without any possibility of reconstruction due to the malacic wall. The artery was then ligated, and the postoperative course was uneventful. Small radial PSA following arterial catheterization may be complicated by sudden rupture in patients with COVID-19. Vascular surgeons should therefore be aware of such complication to prevent potentially serious consequences.