JACC. Case reports · 2025
"String Cheese" Partial Radial Artery Avulsion in a Patient Undergoing Cardiac Catheterization and Percutaneous Coronary Intervention: String Cheese Avulsion.
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Casazza Richard, Epstein David J, Malik Bilal, Pittman Meredith, Montagna Enrico, Angeles Paul, Wong Edward, Hashmi Arsalan
Аннотация
BACKGROUND: Radial artery avulsion (RAV) is a rare but potentially serious complication of transradial angiographic procedures.
CASE SUMMARY: We describe a 70-year-old man who presented with atypical chest discomfort and who underwent cardiac catheterization from the right radial artery. The patient had radial artery spasm, and a piece of tissue approximately 6 cm in length was pulled out of the sheath. Pathological evaluation revealed a partial arterial intimal layer. The intima was avulsed off the arterial wall because of either the spasm or catheter-induced trauma. Conservative management was used to treat the patient.
DISCUSSION: Our case demonstrates the appearance of a partial RAV, otherwise coined "string cheese" avulsion, during transradial catheterization. Furthermore, we provide a system for classifying different types of RAVs.
TAKE-HOME MESSAGES: RAV type can be determined by the appearance of the tissue avulsed. Determination of RAV type can potentially guide management strategies.
CASE SUMMARY: We describe a 70-year-old man who presented with atypical chest discomfort and who underwent cardiac catheterization from the right radial artery. The patient had radial artery spasm, and a piece of tissue approximately 6 cm in length was pulled out of the sheath. Pathological evaluation revealed a partial arterial intimal layer. The intima was avulsed off the arterial wall because of either the spasm or catheter-induced trauma. Conservative management was used to treat the patient.
DISCUSSION: Our case demonstrates the appearance of a partial RAV, otherwise coined "string cheese" avulsion, during transradial catheterization. Furthermore, we provide a system for classifying different types of RAVs.
TAKE-HOME MESSAGES: RAV type can be determined by the appearance of the tissue avulsed. Determination of RAV type can potentially guide management strategies.