Sheath-Induced Sterile Abscesses

J INVASIVE CARDIOL 2020;32(10):E263. 

Key words: abscess, access-site complication, radial access complication

A 48-year old man underwent coronary angiography and revascularization for acute coronary syndrome via the right radial artery route. A 6 Fr hydrophilic arterial sheath was used for the procedure. On postoperative day 1, the patient complained of swelling and a small blister formation over the radial access site. The blister progressively increased in size over the next 3 days, with formation of additional large blisters and bulla nearby (Figures 1A and 1B). Culture from the blister fluid was negative for pathogens. A diagnosis of sheath-induced sterile inflammatory reaction was made. The patient was managed conservatively with antihistamines and regular dressings. The lesions resolved in 2-3 weeks. At 6 months, there was minimal scarring (Figure 1C).

Sterile inflammatory reactions at vascular access sites have rarely been reported in the literature. Simple conservative treatment, as in this case, can lead to resolution of even extensive sterile abscesses.

From the Institute of Post Graduate Medical Education & Research and SSKM Hospital, Kolkata, India. 

Disclosure: The authors have completed and returned the ICMJE Form for Disclosure of Potential Conflicts of Interest. The authors report no conflicts of interest regarding the content herein.

The authors report that patient consent was provided for publication of the images used herein.

Manuscript accepted January 8, 2020.

Address for correspondence: Rakesh Agarwal, MBBS, MD, DM, IPGME&R and SSKM Hospital, AJC Bose Road, P.S-Bhowanipur, Kolkata-700020, India. Email: dr.agarwal.rakesh@hotmail.com