Renal Subcapsular Hematoma Post Transradial Catheterization

Area of Science:

• Cardiology
• Interventional Cardiology
• Vascular Surgery

Background:

• Transradial cardiac catheterization is a minimally invasive alternative to transfemoral access.
• Percutaneous coronary intervention (PCI) via radial approach is increasingly common.
• Subcapsular hematomas are rare complications of cardiac catheterization.

Observation:

• A patient presenting with chest pain underwent successful PCI with a drug-eluting stent via transradial access.
• The procedure involved significant heparinization to achieve an activated clotting time (ACT) of 242 seconds.
• Post-procedure, the patient developed hemodynamic instability.

Findings:

• The first documented case of a renal subcapsular hematoma following transradial cardiac catheterization.
• The hematoma was identified as the cause of the patient's critical condition.
• This contrasts with the traditional association of such hematomas with transfemoral approaches.

Implications:

• Highlights a rare but serious complication of transradial cardiac catheterization.
• Suggests the need for increased vigilance for retroperitoneal bleeding in patients undergoing transradial procedures, even with successful outcomes.
• May inform procedural guidelines and post-catheterization monitoring protocols.