Retention and fracture of a hydrophilic radial artery sheath due to severe spasm

Worldwide, there is increasing interest in transradial intervention, as it appears safer, more cost-effective and is the preferred access route for patients over transfemoral intervention. The favorable neuroanatomical relationships of the radial artery mean that access-site complications are extremely rare. However, radial access-site complications do occur and we report a case of radial artery spasm preventing radial sheath removal, refractory to repeated administration of radial artery vasodilators, intra-arterial papaverine and conscious sedation. Sheath removal was ultimately only possible using an open surgical approach. Radial operators need to be aware of the management of this rare but significant clinical complication.