A rare ,but potentially dangerous, complication of radial angioplasty is the development of such a large forearm hematoma that a compartment syndrome can develope. This needs prompt decompression. This can successfully be done by the use of leeches placed on the arm.    

On Nov 10th, 99, we preformed a heart cath and LAD PTCA and stent on a 78 year old lady using a 6 Fr right radial approach. It was noted on initial introduction of the 6 Fr Boston Scientific Kimny guide that the radial artery was very tortuous just before the elbow. The case was unremarkable and the patient never complained of any pain in her arm. 6 hours later, while still in hospital, a forearm hematoma started to develop. Compression at the radial puncture site was applied but after 1 hour the patients hand started to swell and she complained of loss of sensation. A physician applied manual compression for 40 minutes and became concernd over the continued loss of sensation and an increasing cyanosis of the hand. Referral was made for consideration of decompression.