BMJ Case Reports 2013; doi:10.1136/bcr-2012-007732

Rare vascular perforation complicating radial approach to percutaneous coronary angioplasty

  1. Aditya Sarma2
  1. 1Department of Cardiology, BHRUT, Ilford, UK
  2. 2Department of Anaesthetics, Guys and St. Thomas NHS Trust, London, UK
  1. Correspondence to Dr Fahad Farooqi, fahad.farooqi{at}


A transradial arterial approach to coronary angiography and percutaneous coronary intervention has become increasingly embraced by cardiologists as it is associated with decreased vascular complications and allows early mobilisation of patients when compared with transfemoral arterial access. Major vascular complication post-transradial access is uncommon. We describe a very rare case of perforation of the costocervical trunk (a branch of the right subclavian artery at the site of the thoracic inlet) presenting shortly after percutaneous transradial coronary intervention. The resulting rapidly expanding cervical haematoma caused airway compromise necessitating emergent intubation in the catheter laboratory recovery area. Transfemoral catheter coil embolisation of the feeder artery was successful in obliterating blood flow to the perforated vessel with eventual resolution of the neck haematoma.

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