scholarly journals Odynophagia after Cardiac Catheterization: A Rare Complication in the Presence of Aberrant Subclavian Artery

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Moumita Naidu ◽  
Robby Singh ◽  
Marcel Zughaib
Keyword(s):  
Cardiac Catheterization ◽  
Subclavian Artery ◽  
Rare Complication ◽  
Fluid Collection ◽  
Good Condition ◽  
Vascular Complications ◽  
Aberrant Right Subclavian Artery ◽  
Mediastinal Hematoma ◽  
Aberrant Subclavian Artery ◽  
Life Threatening

Background. Vascular complications from transradial cardiac catheterization are uncommon. Mediastinal hematoma is a rare complication with life-threatening potential. We present a case of a patient who underwent cardiac catheterization and subsequently experienced odynophagia from injury to an aberrant subclavian artery that led to a mediastinal hematoma. Case Report. A 59-year-old female with past medical history of coronary artery disease presented with complaints of angina and underwent a transradial cardiac catheterization. Immediately after the procedure, the patient complained of chest pain and odynophagia. EKG and echocardiogram were unremarkable, and a CT scan of the chest demonstrated an ill-defined fluid collection present in the superior mediastinum and an aberrant right subclavian artery. The patient was closely monitored in the Intensive Care Unit, and the patient remained hemodynamically stable throughout the admission. The patient was subsequently discharged home in good condition and did well on outpatient follow-up. Conclusion. Vascular injuries associated with delivery of standard radial catheters in the subclavian artery are rare, with very few cases reported in the literature. We presented the case of a patient who had a previously unidentified right aberrant subclavian artery with a retroesophageal course which precipitated the hematoma and subsequently resulted in odynophagia despite an uncomplicated catheterization. This rare complication of a commonplace procedure necessitates prompt recognition, appropriate hemodynamic management, and possible repair of the injured vessel to appropriately manage a potentially life-threatening condition.

Challenges in the management of coarctation of the aorta

2020 ◽  
pp. 145-162
Author(s):  
Salim Jivanji ◽  
Robin HS Chen ◽  
Eric Rosenthal
Keyword(s):  
Cardiac Catheterization ◽  
Subclavian Artery ◽  
Successful Treatment ◽  
Conservative Management ◽  
Somatic Growth ◽  
Coarctation Of The Aorta ◽  
Aberrant Right Subclavian Artery ◽  
The Common

A postnatally diagnosed child underwent stenting of his native coarctation of the aorta after initial conservative management. After successful treatment of his coarctation, he was followed up regularly and was noted to develop hypertension. Subsequent investigations confirmed that he required further dilatation of his stent in view of somatic growth. Cardiac catheterization revealed an aneurysm at the site of the previous stenting. Given his aberrant right subclavian artery (ARSCA), the procedure was terminated with a view to the best method of treatment. He subsequently underwent re-stenting of his coarctation, with protection of his ARSCA with a balloon over a wire. The chapter explores the challenges in managing this condition using angioplasty, stenting, or surgery, and the common pitfalls that are encountered in the life of patients with this condition.

Prenatal diagnosis of right aberrant subclavian artery with other congenital anomalies at I trimester of gestation

2019 ◽  
Author(s):  
M.V. Medvedev, N.A. Altynnik, A.I. Zamiatina et all
Keyword(s):  
Prenatal Diagnosis ◽  
Subclavian Artery ◽  
Congenital Anomalies ◽  
Congenital Abnormalities ◽  
Prenatal Ultrasound ◽  
Ultrasound Diagnosis ◽  
Aberrant Right Subclavian Artery ◽  
Aberrant Subclavian Artery ◽  
The Right ◽  
Multiple Congenital Abnormalities

Six cases of prenatal ultrasound diagnosis of aberrant right subclavian artery at 12+2–14+2 weeks of gestation are presented. To 5 cases earlier published was added a case of prenatal diagnosis of the right aberrant subclavian artery in fetus with multiple congenital abnormalities at 13+3 weeks of gestation. Opportunities of early prenatal ultrasound diagnosis of the right aberrant subclavian artery on first screening are discussed.

Cerebellar hemorrhage and subsequent venous infarction followed by incomplete transvenous embolization of dural carotid cavernous fistulas: a rare complication

2008 ◽  
Vol 108 (6) ◽  
pp. 1245-1248 ◽  
Author(s):  
Reng-Jye Lee ◽  
Chih-Feng Chen ◽  
Shih-Wei Hsu ◽  
Chun-Chung Lui ◽  
Yeh-Lin Kuo
Keyword(s):  
Early Recognition ◽  
Rare Complication ◽  
Vascular Complications ◽  
Transvenous Embolization ◽  
Blurred Vision ◽  
Cerebellar Hemorrhage ◽  
Life Threatening ◽  
Venous Infarcts ◽  
Carotid Cavernous Fistulas

✓ Endovascular therapy for dural carotid cavernous fistulas (CCFs) is generally accepted to be safe and effective. The authors report a rare complication of hemorrhage and subsequent venous infarcts of the pons and cerebellum after transvenous embolization. This 41-year-old man presented with a severe left frontal headache, congestion of the left conjunctiva, blurred vision, and photophobia. Cerebral angiography demonstrated a right dural CCF. The patient underwent transvenous embolization of the cavernous sinus but had the initial complication of cerebellar hemorrhage. One month later, he developed progressive dizziness, ataxia, and right-sided weakness. Magnetic resonance imaging revealed severe cerebellar and pontine edema. The cause was a residual fistula combined with delayed occlusion of the inferior petrosal sinus. The fistula was obliterated after repeated embolizations. The patient's symptoms gradually resolved, and there was no evidence of recurrence during the 4-year follow-up period. Incomplete transvenous embolization of a dural CCF can result in life-threatening vascular complications due to redistribution of shunt flow. Early recognition of redistributed drainage and preventive placement of coils at the origin of draining veins during the procedure could avert this rare complication.

Delayed Subclavian Artery Aneurysm Following Fixation of a Clavicular Fracture

2018 ◽  
Vol 52 (6) ◽  
pp. 459-462 ◽  
Author(s):  
Scott John Charles Pallett ◽  
Isabelle Singh ◽  
Neveen Rady ◽  
Hemprakesh Goshai
Keyword(s):  
Primary Care ◽  
Subclavian Artery ◽  
Plate Fixation ◽  
Delayed Diagnosis ◽  
Vascular Complications ◽  
Artery Aneurysm ◽  
Subclavian Artery Aneurysm ◽  
Life Threatening ◽  
History Of ◽  
Rare Phenomena

Aneurysms of the subclavian artery are rare phenomena that have the potential for limb and life-threatening complications. Delayed diagnosis increases the risk of life-threatening complications or at the very least may result in a detrimental effect to both functional capacity and quality of life; primary care offers a vital opportunity to screen for such rare vascular complications and should be a consideration in all patients with evolving peripheral nerve or vascular symptoms with a history of localized clavicular trauma. We present the case of a left subclavian artery aneurysm with radial artery thrombotic sequelae following an injury and screw–plate fixation of his left clavicle. This required a 2-stage surgical approach to treatment and provides useful learning considerations for identifying rare vascular anomalies early in a primary care setting.

scholarly journals Rare case of postoperative mediastinitis following thyroidectomy

2021 ◽  
Vol 17 (1) ◽  
pp. 52-55
Author(s):  
In Soo Cho ◽  
Moo Hyun Lee ◽  
Jihyoung Cho
Keyword(s):  
Esophageal Perforation ◽  
Surgical Intervention ◽  
Rare Complication ◽  
Fluid Collection ◽  
Unusual Complication ◽  
Anterior Neck ◽  
Life Threatening ◽  
Additional Imaging ◽  
Life Threatening Complication ◽  
Cervical Esophageal Perforation

Descending necrotizing mediastinitis (DNM) is a life-threatening complication secondary to oropharyngeal abscesses, cervical esophageal perforation, or neck infections spreading along the fascial planes into the mediastinum. Post-thyroidectomy surgical site infection is a highly unusual complication that is typically localized around the incision, but may be propagated into the mediastinum, causing DNM. We encountered a case of this rare complication after thyroidectomy. The patient was a 33-year-old woman who was admitted to our center for left hemithyroidectomy. The surgery was performed without any intraoperative events. However, she later developed fever, hypotension, and tachycardia. Imaging revealed deep neck emphysema and focal pneumomediastinum with infiltration in the anterior neck and mediastinum with abscess formation. Additional imaging at 7 days postoperatively revealed reduced fluid collection deep in the neck with minimal changes in fluid collection in the mediastinum. Esophageal perforation was excluded via an esophagogram, which lead to the conclusion that the infection may have been caused by open thyroidectomy. The patient was treated with prompt medical and surgical intervention. After treatment, she was discharged from the hospital with no further complications. We present our case report as well as a literature review of the diagnosis and treatment of this disease.

scholarly journals Vascular Complications of Transradial Access for Cardiac Catheterization

2021 ◽  
Vol 15 ◽  
Author(s):  
Tanawan Riangwiwat ◽  
James C Blankenship
Keyword(s):  
Radial Artery ◽  
Cardiac Catheterization ◽  
Rare Complication ◽  
Vascular Complications ◽  
Daily Practice ◽  
Artery Occlusion ◽  
Prompt Treatment ◽  
Hand Ischemia ◽  
Transradial Access ◽  
Radial Artery Occlusion

Transradial access has been increasingly adopted for cardiac catheterization. It is crucial for operators to recognize potential vascular complications associated with radial artery access. Prevention, early detection, and prompt treatment of vascular complications are essential to prevent serious morbidities. This review aims to raise awareness of transradial access vascular complications. Radial artery spasm is treated with intra-arterial verapamil and/or nitroglycerine. Hemorrhagic complications, such as perforation, hematoma, arteriovenous fistula, and pseudoaneurysm, are treated with prolonged compression. Patent hemostasis and adequate anticoagulation are used to prevent radial artery occlusion. Hand ischemia is a rare complication not associated with abnormal results of the Allen or Barbeau test, and can be treated with intra-arterial verapamil, IV heparin, and IV diltiazem. Finally, an attentive monitoring protocol for the timely detection of vascular complications should be implemented in daily practice.

scholarly journals Fulminant necrotizing fasciitis of the thigh, following an infection of the sacro-iliac joint in an immunosuppressed, young woman

2015 ◽  
Vol 7 (3) ◽  
Author(s):  
Martin Gothner ◽  
Marcel Dudda ◽  
Christiane Kruppa ◽  
Thomas A. Schildhauer ◽  
Justyna Swol
Keyword(s):  
Drug Abuse ◽  
Soft Tissue ◽  
Necrotizing Fasciitis ◽  
Rare Complication ◽  
Good Condition ◽  
Surgical Debridement ◽  
Soft Tissue Coverage ◽  
Immunosuppressed Patients ◽  
Life Threatening ◽  
Split Skin

Necrotizing soft tissue infection of an extremity is a rare but life-threatening disease. The disease is an infection that involves the soft tissue layer and is characterized by rapidly spreading inflammation (especially of the fascial planes and the surrounding tissues) with a high mortality. Early diagnosis is essential for the outcome of the patients. Radical surgical debridement is the treatment of choice. The predisposing factors are immunosuppression, diabetes mellitus and drug abuse. This report presents a case of necrotizing fasciitis in the thigh, following an abscess of the sacro-iliac joint, as a rare complication in a young, immunosuppressed woman. The patient’s history revealed intra-venous drug abuse and hepatitis C. After immediate diagnosis by magnetic resonance imaging, radical surgical debridement was required and performed. Prior to soft tissue coverage with a split skin graft, five additional sequential debridements were necessary. During her hospital stay, the patient experienced further cerebral and pulmonary septic embolisms and an infection of the elbow. Six months after admission, the patient was discharged in good condition to a rehabilitation center. Necrotizing fasciitis is a life-threatening complication following an abscess of the sacro-iliac joint. Physicians must be vigilant to inflammatory signs and pain in immunosuppressed patients. An abscess of the sacro-iliac joint is rare, but complications of an untreated abscess can be fatal in these patients.

Spontaneous aberrant right subclavian arterio-oesophageal fistula in a previously healthy child

2014 ◽  
Vol 25 (7) ◽  
pp. 1425-1427 ◽  
Author(s):  
Michael R. Joynt ◽  
Ronald G. Grifka
Keyword(s):  
Foreign Body ◽  
General Population ◽  
Aortic Arch ◽  
Subclavian Artery ◽  
Critically Ill Patients ◽  
Healthy Child ◽  
Rare Complication ◽  
Aberrant Right Subclavian Artery ◽  
Unique Case ◽  
Aortic Arch Anomaly

AbstractAn aberrant right subclavian artery arising from a left aortic arch is the most frequently described congenital aortic arch anomaly, occurring in 0.5 to 2.3% of the general population. Despite the retro-oesophageal course of the aberrant subclavian artery, an arterio-oesophageal fistula is an uncommon finding, only previously reported as a very rare complication in critically ill patients with oesophageal instrumentation or foreign body ingestion. We describe a unique case of a spontaneous aberrant right subclavian arterio-oesophageal fistula without an inciting event in a 17-month-child.

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