Subclavian artery perforation complicating coronary angiography

Habib, N.; Jerzewski, Anastasia; Koomen, Egbert M.; Groenemeijer, Björn E.; Waalewijn, Reinier A.; Braam, Richard L.; Hove, Wim ten; Overtoom, T. T. C.

doi:10.1007/s12471-011-0164-7

Cited by 11 publications

(10 citation statements)

References 8 publications

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“…Habib et al described the case of a 79-year-old woman in whom perforation of the subclavian artery occurred during cardiac catheterisation via the radial artery, and the patient was treated by a covered stent. [8] Fahad Farooqi et al described an unusual small bi-lobed pseudoaneurysm originating from the right costocervical artery during PCI. This leakage was successfully treated by coil embolisation of the feeder artery.…”

Section: Discussionmentioning

confidence: 99%

Salvage therapy for subclavian artery perforation resulting in mediastinal hematoma during percutaneous coronary intervention

Li¹,

Shi

Li³

2019

Medicine

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Rationale: Transradial access (TRA) is a widely used technique during percutaneous coronary intervention (PCI). However, mediastinal and cervical hematomas, the rare and severe complications of transradial approach, have extremely high mortality rates. To the best of our knowledge, there were no medical literatures about the successful anticoagulation reversal procedure of mediastinal hematoma in PCI till now. Patient concerns: We here present a 54-year-old male Han patient who underwent PCI. Immediately after PCI, he reported an episode of neck and chest discomfort, dyspnea, cough recurrence, and cold sweats. Emergency chest computed tomography (CT) revealed a perforation of the subclavian artery resulting in a large mediastinal hematoma with potentially lethal tracheal compression. Diagnosis: A diagnosis of the large mediastinal hematoma was made based on the enhanced computed tomography. Interventions: The patient was successfully managed with palliative therapy of anticoagulation reversal instead of a covered stent graft and surgical operation. Outcomes: Angiography confirmed the absence of leakage after anticoagulation reversal. The patient had an apparent remission of clinical dyspnea. Follow-up CT confirmed an almost entire absorption of the mediastinal hematoma 35 days postdischarge. Lessons: The current case highlights the importance of anticoagulation reversal as well as careful guidewire and guide catheter manipulation by the radial approach. Early evaluation, prompt identification, appropriate treatment, and close monitoring are all essential for invasive cardiology.

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Section: Discussionmentioning

confidence: 99%

Salvage therapy for subclavian artery perforation resulting in mediastinal hematoma during percutaneous coronary intervention

Li¹,

Shi

Li³

2019

Medicine

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“…Vascular perforation associated with delivery of a 6 French guide catheter in the subclavian and brachiocephalic arteries is rare, with few cases reported in the literature [ 6 – 8 ]. In this case, brachiocephalic artery perforation resulted in pseudoaneurysm formation and a large mediastinal hematoma with tracheal compression and stridor.…”

Section: Discussionmentioning

confidence: 99%

Mediastinal Hematoma and Tracheal Compression following Transradial Percutaneous Coronary Intervention

Smilowitz

Sarić

Attubato

et al. 2018

Case Reports in Cardiology

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Vascular complications from transradial percutaneous coronary intervention (PCI) are rare. We report an unusual case of stridor after PCI due to brachiocephalic artery perforation, pseudoaneurysm formation, and development of a large mediastinal hematoma with tracheal compression. Endovascular repair of the brachiocephalic artery was achieved with covered stent placement at the neck of the pseudoaneurysm. This case highlights the importance of careful guide catheter placement from the right radial approach. Ultimately, rapid diagnosis of vascular perforation, appropriate airway management, and prompt endovascular repair of the injured vessel is critical to the successful management of this life-threatening condition.

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“…There has been one similar case report published previously,2 which indicates that such a complication, whilst rare, is possible. Endovascular treatment for vascular trauma has been shown to have a 96.9% success rate for stent placement and 84.4% follow-up stent patency 3…”

Section: Descriptionmentioning

confidence: 65%

Iatrogenic perforation of subclavian artery as a complication of coronary angiography from the radial route, endovascularly repaired with a covered stent-graft

2013

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Subclavian artery perforation complicating coronary angiography

Cited by 11 publications

References 8 publications

Salvage therapy for subclavian artery perforation resulting in mediastinal hematoma during percutaneous coronary intervention

Salvage therapy for subclavian artery perforation resulting in mediastinal hematoma during percutaneous coronary intervention

Mediastinal Hematoma and Tracheal Compression following Transradial Percutaneous Coronary Intervention

Iatrogenic perforation of subclavian artery as a complication of coronary angiography from the radial route, endovascularly repaired with a covered stent-graft

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