title: Increased airway pressure due to superior mediastinal hematoma during endovascular coiling by transcarotid approach.
abstract: An elderly woman with subarachanoid hemorrhage presented to our interventional neuroradiology suite for coil embolization of multiple intracranial aneurysms. The patient had difficult vascular access for the passage of microcatheter; hence, the embolization procedure was carried out with direct puncture of the left common carotid artery. During the procedure, the patient developed thromboembolism which was treated by administration of an antiplatelet agent, abciximab. At the end of procedure, she developed airway compromise due to extension of a local neck hematoma into the superior mediastinum. The management issues in such a scenario have been discussed.
authors.affiliation: Department of Neuroanaesthesiology & Critical Care, All India Institute of Medical Sciences (A.I.I.M.S.), New Delhi, India.
authors.forename: Priyanka
authors.initials: P
authors.lastname: Gupta
authors.affiliation: Department of Neuroanaesthesiology & Critical Care, All India Institute of Medical Sciences (A.I.I.M.S.), New Delhi, India. Electronic address: girijarath@yahoo.co.in.
authors.forename: Girija Prasad
authors.initials: GP
authors.lastname: Rath
authors.affiliation: Department of Neuroanaesthesiology & Critical Care, All India Institute of Medical Sciences (A.I.I.M.S.), New Delhi, India.
authors.forename: Sujoy
authors.initials: S
authors.lastname: Banik
authors.affiliation: Department of Neuroanaesthesiology & Critical Care, All India Institute of Medical Sciences (A.I.I.M.S.), New Delhi, India.
authors.forename: Charu
authors.initials: C
authors.lastname: Mahajan
mesh_terms: D000077284:Abciximab; D000368:Aged; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D020212:Carotid Artery Injuries / Q000209:etiology; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D057510:Endovascular Procedures / Q000009:adverse effects / Q000379:methods; D005260:Female; D006406:Hematoma / Q000150:complications / Q000209:etiology*; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000008:administration & dosage; D002532:Intracranial Aneurysm / Q000628:therapy*; D008477:Mediastinal Diseases / Q000150:complications / Q000209:etiology*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D013345:Subarachnoid Hemorrhage / Q000209:etiology / Q000628:therapy; D013923:Thromboembolism / Q000188:drug therapy / Q000209:etiology
chemical_list: D000911:Antibodies, Monoclonal; D007140:Immunoglobulin Fab Fragments; D010975:Platelet Aggregation Inhibitors; D000077284:Abciximab
keywords: Airway pressure; Endovascular coiling; Hematoma; Subarachnoid hemorrhage; Superior mediastinum; Transcarotid digital substraction angiography