Mediastinal Hematoma as a Potential Complication of Endovascular Intracranial Intervention

Objective To highlight the rare incidence of mediastinal hematoma as a complication associated with transradial access, as reported in both cardiovascular and neurovascular fields. Interventionists must be aware of this potential risk and the strategies to manage it. Case Presentation A 66‐year‐old...

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Main Authors: Salvador F. Gutierrez‐Aguirre, Otavio F. De Toledo, Eduarda M. Freitas, Victor H.C. Benalia, Amin Aghaebrahim, Ricardo A. Hanel, Eric Sauvageau
Format: Article
Language:English
Published: Wiley 2024-11-01
Series:Stroke: Vascular and Interventional Neurology
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Online Access:https://www.ahajournals.org/doi/10.1161/SVIN.124.001437
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author Salvador F. Gutierrez‐Aguirre
Otavio F. De Toledo
Eduarda M. Freitas
Victor H.C. Benalia
Amin Aghaebrahim
Ricardo A. Hanel
Eric Sauvageau
author_facet Salvador F. Gutierrez‐Aguirre
Otavio F. De Toledo
Eduarda M. Freitas
Victor H.C. Benalia
Amin Aghaebrahim
Ricardo A. Hanel
Eric Sauvageau
author_sort Salvador F. Gutierrez‐Aguirre
collection DOAJ
description Objective To highlight the rare incidence of mediastinal hematoma as a complication associated with transradial access, as reported in both cardiovascular and neurovascular fields. Interventionists must be aware of this potential risk and the strategies to manage it. Case Presentation A 66‐year‐old woman presented to an outside hospital's emergency department with 2 months of dizziness and vertigo. A right posterior communication artery aneurysm was discovered incidentally on workup images. On discussing potential options, including observation, the patient opted for endovascular intervention. The aneurysm was treated using a Woven Endobridge Single‐Layer Sphere (SLS) intrasaccular flow disrupter device. After the procedure, the patient was extubated but subsequently required reintubation because of the context of stridor. Radiologic evaluation revealed a mediastinal hematoma, which was suspected to be a direct complication from the transradial access. This required immediate treatment with coil embolization of the perforated vessel at the subclavian artery originating from the costocervical trunk. Conclusion Mediastinal hematoma is a rare complication after neurointerventional procedures by transradial access. Prompt diagnosis and appropriate treatment are critical to managing this potentially lethal condition.
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spelling doaj-art-e2cc012fd47d40769b1a3b21d11f07b62025-08-20T03:07:41ZengWileyStroke: Vascular and Interventional Neurology2694-57462024-11-014610.1161/SVIN.124.001437Mediastinal Hematoma as a Potential Complication of Endovascular Intracranial InterventionSalvador F. Gutierrez‐Aguirre0Otavio F. De Toledo1Eduarda M. Freitas2Victor H.C. Benalia3Amin Aghaebrahim4Ricardo A. Hanel5Eric Sauvageau6Baptist Neurological Institute Jacksonville FLBaptist Neurological Institute Jacksonville FLBaptist Neurological Institute Jacksonville FLBaptist Neurological Institute Jacksonville FLBaptist Neurological Institute Jacksonville FLBaptist Neurological Institute Jacksonville FLBaptist Neurological Institute Jacksonville FLObjective To highlight the rare incidence of mediastinal hematoma as a complication associated with transradial access, as reported in both cardiovascular and neurovascular fields. Interventionists must be aware of this potential risk and the strategies to manage it. Case Presentation A 66‐year‐old woman presented to an outside hospital's emergency department with 2 months of dizziness and vertigo. A right posterior communication artery aneurysm was discovered incidentally on workup images. On discussing potential options, including observation, the patient opted for endovascular intervention. The aneurysm was treated using a Woven Endobridge Single‐Layer Sphere (SLS) intrasaccular flow disrupter device. After the procedure, the patient was extubated but subsequently required reintubation because of the context of stridor. Radiologic evaluation revealed a mediastinal hematoma, which was suspected to be a direct complication from the transradial access. This required immediate treatment with coil embolization of the perforated vessel at the subclavian artery originating from the costocervical trunk. Conclusion Mediastinal hematoma is a rare complication after neurointerventional procedures by transradial access. Prompt diagnosis and appropriate treatment are critical to managing this potentially lethal condition.https://www.ahajournals.org/doi/10.1161/SVIN.124.001437aneurysmcase reportcerebral angiographyendovasculartransradial access
spellingShingle Salvador F. Gutierrez‐Aguirre
Otavio F. De Toledo
Eduarda M. Freitas
Victor H.C. Benalia
Amin Aghaebrahim
Ricardo A. Hanel
Eric Sauvageau
Mediastinal Hematoma as a Potential Complication of Endovascular Intracranial Intervention
Stroke: Vascular and Interventional Neurology
aneurysm
case report
cerebral angiography
endovascular
transradial access
title Mediastinal Hematoma as a Potential Complication of Endovascular Intracranial Intervention
title_full Mediastinal Hematoma as a Potential Complication of Endovascular Intracranial Intervention
title_fullStr Mediastinal Hematoma as a Potential Complication of Endovascular Intracranial Intervention
title_full_unstemmed Mediastinal Hematoma as a Potential Complication of Endovascular Intracranial Intervention
title_short Mediastinal Hematoma as a Potential Complication of Endovascular Intracranial Intervention
title_sort mediastinal hematoma as a potential complication of endovascular intracranial intervention
topic aneurysm
case report
cerebral angiography
endovascular
transradial access
url https://www.ahajournals.org/doi/10.1161/SVIN.124.001437
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