Rizk Tony, Patel Darren, Young Emilee, Ramakrishnan Vijay, Mansour Khaled
Interventional Radiology, Edward Via College of Osteopathic Medicine, Blacksburg, USA.
Orthopedics, Edward Via College of Osteopathic Medicine, Blacksburg, USA.
Cureus. 2020 May 7;12(5):e8009. doi: 10.7759/cureus.8009.
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.
由于相对于股动脉途径具有良好的副作用特征，经桡动脉进行心脏导管插入术和经皮冠状动脉介入治疗越来越受欢迎。经桡动脉心脏导管插入术后纵隔血肿在文献中鲜有报道，而且如果存在，出血的确切位置也很少能确定。在本病例报告中，我们描述了一例择期经桡动脉冠状动脉造影术导致椎动脉附近锁骨下动脉穿孔，并随后形成纵隔和颈部血肿的情况。在导线操作过程中突然恶化引发对不良事件的怀疑后，通过立即进行胸部成像对该情况进行了处理。纵隔血肿的形成等同于股动脉途径的腹膜后出血，需要快速识别、多学科协作和血管内治疗。
