Pace Meredith M
From the Department of Anesthesiology, Lahey Hospital and Medical Center, Burlington, Massachusetts.
A A Pract. 2018 Jul 1;11(1):19-21. doi: 10.1213/XAA.0000000000000725.
A 52-year-old man with end-stage renal disease underwent ultrasound-guided infraclavicular brachial plexus block for revision of an arteriovenous fistula. On postoperative day 2, the patient developed pain and loss of motor function in the surgical extremity. A computed tomography angiogram revealed complete dissection of the axillary artery. The dissection was emergently treated with a bypass graft, resulting in complete resolution of paralysis and pain. Sensory deficits resolved over the next 3 days. Smoking, hypertension, diabetes mellitus, and chronic intake of a calcineurin inhibitor might have predisposed the patient to iatrogenic arterial dissection.
