Article
Treatment of acute forearm compartment syndrome after transradial coronary intervention
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Published: | February 6, 2020 |
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Outline
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Objectives/Interrogation: This study documented our experience with acute forearm compartment syndrome after percutaneous coronary intervention via radial artery and suggested caution in order to achieve good results.
Methods: We retrospectively reviewed the records of 4 patients with acute forearm compartment syndrome (ACS) after transradial intervention (TRI) following emergent fasciotomy from 2015 to 2017. The patients included 3 females and 1 male with an average age of 70 years. ACS was diagnosed with clinical symptoms and compartment pressure monitoring and computed tomography angiography to confirm preoperative vascular status was performed in all cases. The time from symptom to operation averaged 5.7 h. The functional outcome was evaluated using a Quick-disabilities of the arm, shoulder and hand (DASH) score, grip and pinch strength at the time of final follow-up.
Results and Conclusions: In three cases, ACS was caused by bleeding from the rupture at the radial artery puncture site, and one case was caused by brachial artery rupture at the level of distal humerus and radial artery rupture at the level of proximal forearm. We obtained satisfactory results without any complications with an average follow-up of 11.5 months (range, 9 to 12). The average Quick DASH score was 15.35. The last follow-up average grip strength was 16 kg and the average pinch power was 1.6kg. All 4 patients were satisfied with the function of the hand.
We stress that if physicians encounter ACS after TRI, they should be aware of the bleeding from the arterial rupture to confirm the preoperative status of artery and early surgical decompression with minimal injury of soft tissue with satisfactory results even in elderly patients.