HAND ISCHAEMIA FOLLOWING RADIAL ARTERY CANNULATION

Digital ischaemia following radial arterial cannulation is uncommon. It is usually the result of thrombotic occlusion of a dominant radial artery. However, factors other than arterial thrombosis per se may operate in the critically ill patient to produce digital ischaemia. The following case presentation includes a review of possible mechanisms of digital ischaemia following radial artery cannulation and discusses the therapeutic options available. Journal of Hand Surgery (British and European Volume, 1995) 20B: 4:493-495 Direct intra-arterial pressure monitoring with the facility for repeated blood sampling are valuable assets to the intensive care physician faced with a critically ill patient. Although popular nd convenient, radial artery cath-eterization can cause vascular compromise of the hand. Between 0.2 % and 10 % of patients at risk develop this complication (Baker et al, 1976; Crossland and Neviaser, 1977). Pre-operative assessment using Allen's test or Doppler to confirm ulnar artery patency and using the smallest possible diameter of catheter for the shortest possible time will reduce the risk of digital ischaemia. When ischaemia of the hand does occur it is usually due to occlusion of the radial artery and superficial palma