ArticleJACC. Case reports2026
Digital Ischemia Following Radial Access Unmasking Systemic Sclerosis: Characteristic Intravascular Ultrasound Findings.
Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundSystemic sclerosis (SSc) is an autoimmune disease characterized by microvascular dysfunction and progressive fibrosis. Vascular injury related to catheter procedures may unmask latent vasculopathy in patients with SSc. CASE SUMMARY: An 81-year-old woman presented with chest pain and mild troponin elevation. Right radial access coronary angiography showed nonobstructive coronary artery disease. One month later, she developed black discoloration of the index and middle fingers. Angiography revealed severe radial artery stenosis at the prior access site, and balloon angioplasty restored flow. Intravascular ultrasound demonstrated homogeneous concentric intimal thickening consistent with fibrotic remodeling. Based on positive anticentromere antibody findings and characteristic skin changes, the patient was diagnosed with SSc. DISCUSSION: This case highlights that radial artery access-induced digital ischemia may represent the initial clinical manifestation of previously unrecognized SSc. TAKE-HOME MESSAGE: Clinicians should be aware that subtle peripheral signs of SSc may predispose patients to ischemic complications after radial artery access.
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