# Mediastinal hematoma following transradial percutaneous coronary intervention: case report and literature review

## TL;DR

A rare case of mediastinal hematoma after a heart procedure is reported, emphasizing the need for caution and timely treatment.

## Contribution

Highlights a rare complication of transradial PCI and provides insights into its diagnosis and treatment.

## Key findings

- Mediastinal hematoma occurred due to a ruptured subclavian artery branch after transradial PCI.
- Timely interventional embolization therapy was critical for managing the complication.
- Use of hydrophilic-coated curved-tip guidewires requires caution to prevent such complications.

## Abstract

Mediastinal hematoma due to transradial PCI is rare. We reported a case of chest tightness, dyspnea, progressive neck swelling after transradial PCI. Clinical examinations such as chest computer tomography were completed and identified as mediastinal hematoma caused by a rupture of the subclavian artery branch and occlude the artery under digital subtraction angiography guidance, the artery was considered to be a collateral vessel of non-bronchial arterial circulation. This case highlights the necessity of exercising extreme caution when utilizing hydrophilic-coated curved-tip guidewires during the advancement process in peripheral vascular procedures. Mediastinal hematoma is a life-threatening complication and progresses rapidly, we need timely identification and diagnosis based on symptoms and appropriate clinical examination, interventional embolization therapy is critical for patients with poor response of conservative treatment.