Pulsating mass following plain old balloon angioplasty on left anterior descending artery (LAD) via radial access

BACKGROUND: Trans-radial coronary intervention is a popular technique due to patient comfort and lower complication rate. The main complications of this method are artery spasm, vessel perforation, and formation of pseudo-aneurysm. CASE REPORT: In this report, an unusual complication of radial access angiography was encountered. Shortly after the procedure, the patient’s right arm began to swell and a pulsating mass grew over the medial aspect of the arm. Right brachial artery angiography was performed immediately for rolling out brachial artery perforation. There was no evidence of extravasation in brachial angiography. Surprisingly, the mass began to disappear after some active flexion and extension at elbow joint. The same problem occurred again after percutaneous coronary intervention (PCI) on left anterior descending artery (LAD) in this case 2 days later and was resolved by the same maneuver. CONCLUSION: It can be conculded that the brachial artery path was shifted and became entrapped after the procedure due to low soft tissue support.