A Case of Huge Scrotal Hematoma during Mechanical Thrombectomy

OBJECTIVE: We report a case of huge scrotal hematoma during emergency mechanical thrombectomy. CASE PRESENTATION: An 85-year-old man presented with sudden aphasia and right-sided hemiplegia. He was diagnosed with cerebral infarction due to left M1 occlusion and underwent an emergency mechanical thrombectomy. The treatment was completed with full recanalization, but when replacing the long sheath in the right femoral artery with a short sheath, the patient flexed his leg. The sheath could not be replaced, resulting in a massive scrotal hematoma. Shortly after, the patient went into cardiopulmonary arrest but recovered spontaneous circulation after cardiopulmonary resuscitation. The puncture site was treated hemostatically with manual compression, and the scrotal hematoma was not enlarged. He was transferred to another hospital with a modified Rankin Scale score of 5. CONCLUSION: Scrotal hematoma is a rare but potentially fatal puncture site complication that should be considered during neuro-endovascular treatment.