Delayed Hemodynamic Collapse From Subclavian Artery Perforation Following Transradial Coronary Intervention, Requiring Rescue Endovascular Stenting

We report a case of a 53-year-old man who developed proximal right subclavian artery perforation during coronary angiography and percutaneous coronary intervention, leading to a large mediastinal hematoma and resultant delayed hemodynamic collapse.Although initial angiography demonstrated a proximal subclavian artery dissection, subtle contrast extravasation was only identified on retrospective review.Subsequent hemodynamic deterioration prompted computed tomography angiography, which demonstrated active arterial extravasation and a large mediastinal hematoma requiring emergency intervention.