Multidisciplinary Management of Subclavian Artery Perforation and Complications - PubMed (original) (raw)

Case Reports

Multidisciplinary Management of Subclavian Artery Perforation and Complications

Tony Rizk et al. Cureus. 2020.

Abstract

The radial approach to cardiac catheterization and percutaneous coronary interventions has increased in popularity due to the favorable side effect profile relative to the femoral approach. Mediastinal hematoma after radial access cardiac catheterization has scarcely been reported in the literature and, if present, the exact location of the bleed was rarely identified. In this case presentation, we describe an elective transradial coronary angiography resulting in subclavian artery perforation in close proximity to the vertebral artery, with subsequent mediastinal and cervical hematoma formation. This scenario was managed by immediate imaging of the chest after sudden deterioration raised suspicion of an adverse event during wire navigation. Formation of a mediastinal hematoma is the equivalent of retroperitoneal bleed from the femoral approach and requires rapid recognition, interdisciplinary collaboration, and endovascular management.

Keywords: distal radial artery access; distal radial artery approach; extrapleural hematoma; interventional cardiology; interventional radiology; mediastinal hematoma; percutaneous procedure; right radial artery access; subclavian artery perforation; thoracic radiology.

Copyright © 2020, Rizk et al.

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Conflict of interest statement

The authors have declared that no competing interests exist.

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