초록접수 현황
| 19F-065 | 포스터 발표 |
Forearm Compartment Syndrome following Thrombolytic Therapy for Arterial Thoracic Outlet Syndrome
Seong Cheol Jeong, Yong Hwan Kim, Jung Wook Han, Jae Jun Kim, Insub Kim
Department of Thoracic and Cardiovascular Surgery, Uijeongbu St. Mary`s Hospital, The Catholic University College of Medicine, Gyeonggi-do, Republic of Korea
Purpose : Forearm compartment syndrome following thrombolytic treatment without manipulation or injury to the ipsilateral arm is very rare. Herein, we present a patient with arm compartment syndrome following thrombolysis due to arterial TOS.
Methods : A 24-year-old-man presented with left forearm coldness, pain and cyanosis. On physical examination, the patient’s left hand was cyanotic with absent brachial pulses. Computed tomography revealed the left cervical rib and narrowing of the left thoracic outlet, resulting in compression of the left subclavian artery and probably brachial plexus.We performed thrombolytic therapy via infusion catheter placed in the left brachial artery via left common femoral artery because of extensive and complete obstruction of palmar artery. After 21 h, edema and pain was observed in the left forearm, along with pinkish coloration of the hand; the CPK was 10631 U/L. Angiography showed obstruction of radial artery and opacification of palmar arch by blood supplying the ulnar artery without arterial rupture. The orthopedic team performed fasciotomy extending from the wrist to the elbow junction. No arterial injury was established.
Results : After 13 days, the delayed wound was closed with split-thickness skin graft obtained from the right thigh. After the wound in the left arm was healed, we performed excision of the cervical rib. A follow-up CT angiography after 5 months revealed well-opacified palmar arch through the ulnar collateral arteries.
Conclusion : Forearm compartment syndrome after thrombolytic therapy for arterial TOS has not previously been reported. We herein presented a case of a 24-year-old-man with an unusual case of thrombolytic complications in TOS.
Methods : A 24-year-old-man presented with left forearm coldness, pain and cyanosis. On physical examination, the patient’s left hand was cyanotic with absent brachial pulses. Computed tomography revealed the left cervical rib and narrowing of the left thoracic outlet, resulting in compression of the left subclavian artery and probably brachial plexus.We performed thrombolytic therapy via infusion catheter placed in the left brachial artery via left common femoral artery because of extensive and complete obstruction of palmar artery. After 21 h, edema and pain was observed in the left forearm, along with pinkish coloration of the hand; the CPK was 10631 U/L. Angiography showed obstruction of radial artery and opacification of palmar arch by blood supplying the ulnar artery without arterial rupture. The orthopedic team performed fasciotomy extending from the wrist to the elbow junction. No arterial injury was established.
Results : After 13 days, the delayed wound was closed with split-thickness skin graft obtained from the right thigh. After the wound in the left arm was healed, we performed excision of the cervical rib. A follow-up CT angiography after 5 months revealed well-opacified palmar arch through the ulnar collateral arteries.
Conclusion : Forearm compartment syndrome after thrombolytic therapy for arterial TOS has not previously been reported. We herein presented a case of a 24-year-old-man with an unusual case of thrombolytic complications in TOS.
책임저자: Seong Cheol Jeong
Department of Thoracic and Cardiovascular Surgery, Uijeongbu St. Mary`s Hospital, The Catholic University College of Medicine, Gyeonggi-do, Republic of Korea
발표자: Seong Cheol Jeong, E-mail : icebar000@gmail.com