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Massive Cervical-Mediastinal Hematoma After Transradial Percutaneous Coronary Intervention
Richard Amoateng1, Suhas Rathna Seshadri2, Aakash Balaji2
1Division of Cardiology, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA.
Insights
Mediastinal hematoma is a rare complication of transradial access. A conservative, multidisciplinary approach is effective for managing this serious vascular complication when active bleeding is absent.
Area of Science:
- Cardiology
- Vascular Surgery
Background:
- Transradial access is a common approach for invasive coronary angiography.
- While generally safe, it carries a risk of rare but serious vascular complications.
Observation:
- A case of massive cervical-mediastinal hematoma following a complex percutaneous coronary intervention via transradial access is presented.
- The hematoma led to significant airway compromise, necessitating prolonged mechanical ventilation.
Findings:
- Mediastinal hematoma, though rare, is a potential complication of transradial access.
- Management requires a multidisciplinary approach, especially in cases with airway compromise.
Implications:
- A pathway for safe and efficient management of mediastinal hematoma after transradial access is proposed.
- Conservative management is effective in the absence of active bleeding, highlighting the importance of a multidisciplinary strategy.
Background:
Mediastinal hematoma is a rare complication of transradial access during invasive coronary angiography.
Case Summary:
We present a case of a massive cervical-mediastinal hematoma after a complex percutaneous intervention that resulted in airway compromise and prolonged mechanical ventilation.
Discussion:
We focus on multidisciplinary management and, given limited data in the literature, provide a pathway for a safe and efficient approach to management.
Take-Home Messages:
Transradial access, though safe, can lead to rare but serious vascular complications. Conservative and multidisciplinary approach management is effective when active bleeding is absent.
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