{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:26:10Z","timestamp":1787772370366,"version":"build-2784847793"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>The radial artery route is being increasingly used by interventional cardiologists as a default access site for both diagnostic and interventional coronary procedures, and although rare, serious complications can occur. We herein report a potentially catastrophic complication of radial percutaneous coronary intervention (PCI) in the form of a large mediastinal and retro-left-atrial hematoma from possible subclavian artery injury with tracheal compression and stridor in a 60-year-old female presenting with anteroseptal myocardial infarction having undergone PCI of the left anterior descending artery through right radial access and then planned for a second stage PCI of the right coronary artery. The patient was managed conservatively with close hemodynamic and echocardiographic monitoring, inotrope support, and blood transfusions. Transradial PCI, despite having a better safety profile in terms of bleeding compared to transfemoral PCI, is not without complications. Manipulation of hydrophilic guidewires as well as diagnostic catheters while performing radial procedures can cause injury to conduit vessels, potentially leading to intrathoracic, axillary, and arm hematomas may remain undetectable in the cath lab, presenting late and can pose a diagnostic and management challenge. Decision to proceed toward repeat interventional\/surgical\/\u201dwait and watch\u201d strategy should be guided by the patient's clinical status and noninvasive imaging.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/heartviews.heartviews_149_20","type":"journal-article","created":{"date-parts":[[2024,5,24]],"date-time":"2024-05-24T07:51:38Z","timestamp":1716537098000},"page":"63-67","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Hypotension, Tachypnea, and Stridor Following Radial PCI"],"prefix":"10.4103","volume":"22","author":[{"given":"Anindya","family":"Ghosh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krishnarpan","family":"Chatterjee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roopali","family":"Khanna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aditya","family":"Kapoor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-13-20240902","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1002\/1522-726X(200102)52:2<181::AID-CCD1044>3.0.CO;2-G","article-title":"Coronary angiography through the radial or the femoral approach: The CARAFE study","volume":"52","author":"Louvard","year":"2001","journal-title":"Catheter Cardiovasc Interv"},{"key":"R2-13-20240902","doi-asserted-by":"crossref","first-page":"1419","DOI":"10.1016\/j.jcin.2016.04.014","article-title":"Radial versus femoral access for coronary interventions across the entire spectrum of patients with coronary artery disease: A meta-analysis of randomized trials","volume":"9","author":"Ferrante","year":"2016","journal-title":"JACC Cardiovasc Interv"},{"key":"R3-13-20240902","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1111\/joic.12206","article-title":"Unusual vascular complications associated with transradial coronary procedures among 10,324 patients: Case based experience and treatment options","volume":"28","author":"Tatli","year":"2015","journal-title":"J Interv Cardiol"},{"key":"R4-13-20240902","first-page":"544","article-title":"Management of radial and brachial artery perforations during transradial procedures--a practical approach","volume":"21","author":"Patel","year":"2009","journal-title":"J Invasive Cardiol"},{"key":"R5-13-20240902","first-page":"1","article-title":"Rare vascular perforation complicating radial approach to percutaneous coronary angioplasty?","volume":"2013","author":"Farooqi","year":"2013","journal-title":"BMJ Case Rep"},{"key":"R6-13-20240902","first-page":"1","article-title":"Central vascular complications following elective catheterization using transradial percutaneous coronary intervention?","volume":"1","author":"Merkle","year":"2017","journal-title":"J Investig Med High Impact Case Rep"},{"key":"R7-13-20240902","doi-asserted-by":"crossref","first-page":"bcr2012007602","DOI":"10.1136\/bcr-2012-007602","article-title":"Iatrogenic perforation of subclavian artery as a complication of coronary angiography from the radial route, endovascularly repaired with a covered stentgraft","volume":"2013","author":"Abdool","year":"2013","journal-title":"BMJ Case Rep"},{"key":"R8-13-20240902","first-page":"e1","article-title":"Compression syndrome as a complication of percutaneous coronary intervention","volume":"16","author":"Chacko","year":"2011","journal-title":"Exp Clin Cardiol"},{"key":"R9-13-20240902","doi-asserted-by":"crossref","first-page":"2196","DOI":"10.1016\/j.athoracsur.2013.08.025","article-title":"Management of a left atrial intramural hematoma after percutaneous intervention","volume":"97","author":"Jothidasan","year":"2014","journal-title":"Ann Thorac Surg"},{"key":"R10-13-20240902","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1002\/ccd.25571","article-title":"Cardiovascular collapse post chronic total occlusion percutaneous coronary intervention due to a compressive left atrial hematoma managed with percutaneous drainage","volume":"86","author":"Wilson","year":"2015","journal-title":"Catheter Cardiovasc Interv"}],"container-title":["Heart Views"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/HEARTVIEWS.HEARTVIEWS_149_20","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T18:41:41Z","timestamp":1787769701000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/HEARTVIEWS.HEARTVIEWS_149_20"}},"subtitle":["Solving the Conundrum"],"short-title":[],"issued":{"date-parts":[[2021,1]]},"references-count":10,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.4103\/heartviews.heartviews_149_20","relation":{},"ISSN":["1995-705X"],"issn-type":[{"value":"1995-705X","type":"print"}],"subject":[],"published":{"date-parts":[[2021,1]]}}}