This is the first reported case of severe hand hematoma after cardiac catheterization through the distal radial artery, with the hematoma extending distally to the sheath insertion site. The distribution of the hematoma in our case is completely different compared to the hematomas observed after traditional radial catheterization, which used to extend to the forearm. Therefore, the traditional EASY classification may not apply to hematomas after catheterization through the distal radial artery.

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