Avoiding peripheral nerve injury in arterial interventions

Authors: Frank Kuo, Jonathan Park, Kira Chow, Alice Chen, Matthew K. Walsworth

Although peripheral nerve injuries secondary to angiography and endovascular interventions
are uncommon and usually not permanent, they can result in significant functional impairment.
Most arteries used in access for angiography and endovascular therapies lie in close proximity
to a nerve. The nerve may be injured by needle puncture, or by compression from hematoma,
pseudoaneurysm, hemostasis devices, or by manual compression with incidence in literature
ranging from as low as 0.04% for femoral access in a large retrospective study to 9% for brachial
and axillary access. Given the increasing frequency of endovascular arterial procedures and the
increasing use of nontraditional access points, it is important that the interventionalist have a
working knowledge of peripheral nerve anatomy and function as it relates to relevant arterial access sites to avoid injury