Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/17325
Title: Case report: Iatrogenic brachial artery dissection with complete anterograde occlusion during elective arterial line placement.
Authors: Weinberg, Laurence;Abu-Ssaydeh, Diana;Spanger, Manfred;Lu, Patrick;Li, Michael H-G
Affiliation: Department of Anaesthesia, Austin Health, Heidelberg, Victoria, Australia
Department of Surgery, University of Melbourne, Austin Health, Victoria, Australia
Department of Radiology, Box Hill Hospital, Box Hill, Victoria, 3128, Australia
Issue Date: 2018
EDate: 2017-12-27
Citation: International journal of surgery case reports 2018; 42: 269-273
Abstract: Brachial arterial catheters provide a more accurate reflection of central aortic arterial pressure compared to their radial counterparts. Although brachial arterial line complications are uncommon, we report a case of a rare iatrogenic brachial artery dissection with complete anterograde occlusion from elective arterial line placement. A 41-year-old female presented for a right upper and middle lobe resection of a large neuroendocrine lung cancer. A brachial arterial line was inserted for continuous blood pressure monitoring using clinical landmarks. Six hours postoperatively the left hand was noted to be pale, cool and pulseless with complete paraesthesia. Thrombus was initially suspected on computed tomography angiography. Upon return to theatre, extensive dissection of the posterior brachial arterial wall was identified. We review our diagnostic pathway and treatment of this rare complication. Recommendations to minimise the risks of complications from brachial arterial line insertion are also overviewed. We recommend the routine utilization of ultrasound-guided technique and regular post-insertion neurovascular monitoring for the prevention and early recognition of complications from brachial artery catheter insertion.
URI: http://ahro.austin.org.au/austinjspui/handle/1/17325
DOI: 10.1016/j.ijscr.2017.12.034
ORCID: 0000-0001-7403-7680
PubMed URL: 29329067
ISSN: 2210-2612
Type: Journal Article
Subjects: Anaesthesia
Arterial catheter
Brachial artery
Case report
Ischaemia
Appears in Collections:Journal articles

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