Coil Embolization for Management of Brachiocephalic Artery Perforation and Mediastinal Hematoma Following Percutaneous Coronary Intervention

J Invasive Cardiol. 2023 Mar;35(3):E152-E153. doi: 10.25270/jic/22.00170.


In this clinical image vignette, we illustrate the presentation and management of an extremely rare and lethal complica- tion of radial access percutaneous coronary intervention. We present a case of perforation of a small collateral branch of the brachiocephalic artery with subsequent mediastinal hematoma formation and stridor presentation. We suspect the perforation was probably caused by the hydrophilic-coated guidewire. After a multidisciplinary heart team discussion, a percutaneous approach was recommended. We performed the procedure with a single coil embolization of the collateral branch perforation, achieving complete resolution of the hemorrhage.

Keywords: core needle biopsy; perforation; radial access complication.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Arteries
  • Hematoma / diagnosis
  • Hematoma / etiology
  • Hematoma / surgery
  • Hemorrhage
  • Humans
  • Percutaneous Coronary Intervention* / adverse effects