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Central Vascular Complications Following Elective Catheterization Using Transradial Percutaneous Coronary
Julia Merkle1, Christopher Hohmann2, Anton Sabashnikov1
1Department of Cardiothoracic Surgery, Heart Center, University Hospital of Cologne, Cologne, Germany.
Summary
Transradial catheterization for coronary artery disease is generally safe, but severe complications like artery perforation can occur. This case series highlights rare but serious risks associated with this common procedure.
Area of Science:
- Cardiology
- Vascular Surgery
- Interventional Radiology
Background:
- Percutaneous coronary intervention (PCI) is a standard treatment for coronary artery disease.
- Transradial (TRA) and transfemoral (TFA) approaches are common PCI access routes.
- TRA is often preferred due to a lower complication rate compared to TFA.
Purpose of the Study:
- To report two cases of severe central vascular complications following elective transradial coronary angiography.
- To highlight that even elective procedures using the generally safe transradial approach can lead to significant adverse events.
Main Methods:
- Case presentation of two patients undergoing elective transradial coronary angiography.
- Detailed description of the vascular access technique and subsequent complications.
Main Results:
- Both patients experienced severe central vascular complications.
- Case 1: Perforation of the right subclavian artery leading to mediastinal hematoma.
- Case 2: Dissection of the brachiocephalic trunk and aortic arch.
Conclusions:
- While transradial access is typically associated with fewer complications, severe events such as artery dissection and perforation are possible.
- These findings underscore the importance of vigilance and preparedness for rare but serious complications even in elective transradial procedures.
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