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This is a rare complication of coronary angiography via the radial approach in a 69 year old woman being investigated for angina. Diagnosis was made on magnetic resonance angiography (MRA) after the patient presented with a pulsatile mass at the puncture site. The MRA also shows an incomplete palmer arch with the ulnar artery supplying all the fingers except the radial aspect of the index finger and thumb supplied by the radial artery.The incomplete palmar arch meant that vascular reconstruction witha vein patch, rather than ligation alone, was the preferred surgical management. Her recovery was further complicated by the development of amild complexregionalpainsyndrome.
