Fracture and Intravascular Migration of a Radial Arterial Catheter: A Case Report
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Abstract
Background: Arterial catheterization is routinely used for continuous blood pressure monitoring in critically ill patients and during major surgical procedures. Although generally considered safe, catheter-related complications such as intra-arterial fracture and migration are rare but potentially serious and may result in digital ischemia or other vascular complications.
Objective: This case report describes an uncommon episode of arterial catheter fracture followed by intravascular migration and discusses the diagnostic and therapeutic approach to this potentially serious complication.
Case Report: A 45-year-old North African Berber man with no significant medical history was admitted following a road traffic accident resulting in severe traumatic brain injury. During the postoperative period, a sudden flattening of the arterial pressure waveform was observed. Examination revealed that the radial arterial catheter had fractured, with no distal tip visible externally. Radiographs and Doppler ultrasonography demonstrated the fractured catheter within the radial artery. Despite the absence of clinical signs of limb ischemia, the patient underwent successful surgical removal by the vascular surgery team. The affected limb had a favorable outcome.
Conclusion: Arterial catheter fracture with intravascular migration is an uncommon but potentially serious complication. Sudden changes in the arterial waveform should prompt immediate assessment of catheter integrity and position. Early imaging and appropriate intervention are essential to prevent vascular compromise and irreversible limb ischemia.
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