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Brachial plexus impingement secondary to implantable cardioverter defibrillator: A case report
Natalie Jumper,Ishan Radotra,Paulina Witt,Niall G Campbell,Anuj Mishra 대한성형외과학회 2019 Archives of Plastic Surgery Vol.46 No.6
Overall complication rates of 9.1% have been reported following implantable cardioverterdefibrillator (ICD) placement. Brachial plexus injury is infrequently reported in the literature. We describe a 26-year-old female experiencing left arm nerve pain, a positive Tinel’s sign,numbness in the median nerve distribution of the hand and biceps muscle weakness followingrevision ICD via subclavian vein approach. Nerve conduction studies identified severe partialleft brachial plexopathy, which remained incompletely resolved with conservative management. Surgical exploration revealed lateral cord impingement by the ICD generator and aloop of the ICD lead, along with fibrosis, necessitating surgical neurolysis and ICD generatorrepositioning. As increasing numbers of patients undergo cardiac device implantation, it is incumbenton practitioners to be aware of potential increases in the prevalence of this complication.
Brachial plexus impingement secondary to implantable cardioverter defibrillator: A case report
Jumper, Natalie,Radotra, Ishan,Witt, Paulina,Campbell, Niall G,Mishra, Anuj Korean Society of Plastic and Reconstructive Surge 2019 Archives of Plastic Surgery Vol.46 No.6
Overall complication rates of 9.1% have been reported following implantable cardioverter defibrillator (ICD) placement. Brachial plexus injury is infrequently reported in the literature. We describe a 26-year-old female experiencing left arm nerve pain, a positive Tinel's sign, numbness in the median nerve distribution of the hand and biceps muscle weakness following revision ICD via subclavian vein approach. Nerve conduction studies identified severe partial left brachial plexopathy, which remained incompletely resolved with conservative management. Surgical exploration revealed lateral cord impingement by the ICD generator and a loop of the ICD lead, along with fibrosis, necessitating surgical neurolysis and ICD generator repositioning. As increasing numbers of patients undergo cardiac device implantation, it is incumbent on practitioners to be aware of potential increases in the prevalence of this complication.