Left subclavian artery malperfusion due to thoracic outlet syndrome during total vertebrectomy for invasive lung cancer: a case report
Abstract Thoracic outlet syndrome (TOS) can interrupt blood flow to upper limbs by vascular compression. We report a case of a 52-year-old man who presented left subclavian artery malperfusion due to TOS during total vertebrectomy (Th2–4) in the prone position for invasive lung cancer. At the time o...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2017-11-01
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| Series: | JA Clinical Reports |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s40981-017-0131-4 |
| _version_ | 1818918023842496512 |
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| author | Kazuyuki Mizunoya Kentaro Ueda Yoshifumi Takeda Koichi Takita Yuji Morimoto |
| author_facet | Kazuyuki Mizunoya Kentaro Ueda Yoshifumi Takeda Koichi Takita Yuji Morimoto |
| author_sort | Kazuyuki Mizunoya |
| collection | DOAJ |
| description | Abstract Thoracic outlet syndrome (TOS) can interrupt blood flow to upper limbs by vascular compression. We report a case of a 52-year-old man who presented left subclavian artery malperfusion due to TOS during total vertebrectomy (Th2–4) in the prone position for invasive lung cancer. At the time of resection of the vertebral bodies, his left radial systolic blood pressure had begun to drop intermittently and we noticed an interarm pressure difference. Accordingly, we began to monitor the right radial artery pressure and found that only the left radial artery pressure decreased as a result of compressive force from the surgical site. The operation was continued with intermittent malperfusion of the left arm, and when it was prolonged, we asked the surgeons to release the compression. No symptoms of ischemia or nerve injuries in the left arm were observed after the surgery. Retrospective review of his preoperative enhanced computed tomography images suggested a slightly compressed left subclavian artery in the costoclavicular space. Combination of the prone position and a specific upper limb position may be a risk factor for intraoperative TOS. An interarm blood pressure difference is a clue to detect accidental arterial TOS during general anesthesia. |
| first_indexed | 2024-12-20T00:43:22Z |
| format | Article |
| id | doaj.art-4351453b9c1c400c88b2fda17f5892de |
| institution | Directory Open Access Journal |
| issn | 2363-9024 |
| language | English |
| last_indexed | 2024-12-20T00:43:22Z |
| publishDate | 2017-11-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | JA Clinical Reports |
| spelling | doaj.art-4351453b9c1c400c88b2fda17f5892de2022-12-21T19:59:28ZengSpringerOpenJA Clinical Reports2363-90242017-11-01311410.1186/s40981-017-0131-4Left subclavian artery malperfusion due to thoracic outlet syndrome during total vertebrectomy for invasive lung cancer: a case reportKazuyuki Mizunoya0Kentaro Ueda1Yoshifumi Takeda2Koichi Takita3Yuji Morimoto4Department of Anesthesiology, Hokkaido University HospitalDepartment of Anesthesiology, Hokkaido University HospitalDepartment of Anesthesiology, Hokkaido University HospitalDepartment of Anesthesiology, Hokkaido University HospitalDepartment of Anesthesiology, Hokkaido University HospitalAbstract Thoracic outlet syndrome (TOS) can interrupt blood flow to upper limbs by vascular compression. We report a case of a 52-year-old man who presented left subclavian artery malperfusion due to TOS during total vertebrectomy (Th2–4) in the prone position for invasive lung cancer. At the time of resection of the vertebral bodies, his left radial systolic blood pressure had begun to drop intermittently and we noticed an interarm pressure difference. Accordingly, we began to monitor the right radial artery pressure and found that only the left radial artery pressure decreased as a result of compressive force from the surgical site. The operation was continued with intermittent malperfusion of the left arm, and when it was prolonged, we asked the surgeons to release the compression. No symptoms of ischemia or nerve injuries in the left arm were observed after the surgery. Retrospective review of his preoperative enhanced computed tomography images suggested a slightly compressed left subclavian artery in the costoclavicular space. Combination of the prone position and a specific upper limb position may be a risk factor for intraoperative TOS. An interarm blood pressure difference is a clue to detect accidental arterial TOS during general anesthesia.http://link.springer.com/article/10.1186/s40981-017-0131-4Artery malperfusionInterarm pressure differenceThoracic outlet syndromeProne positionTotal vertebrectomy |
| spellingShingle | Kazuyuki Mizunoya Kentaro Ueda Yoshifumi Takeda Koichi Takita Yuji Morimoto Left subclavian artery malperfusion due to thoracic outlet syndrome during total vertebrectomy for invasive lung cancer: a case report JA Clinical Reports Artery malperfusion Interarm pressure difference Thoracic outlet syndrome Prone position Total vertebrectomy |
| title | Left subclavian artery malperfusion due to thoracic outlet syndrome during total vertebrectomy for invasive lung cancer: a case report |
| title_full | Left subclavian artery malperfusion due to thoracic outlet syndrome during total vertebrectomy for invasive lung cancer: a case report |
| title_fullStr | Left subclavian artery malperfusion due to thoracic outlet syndrome during total vertebrectomy for invasive lung cancer: a case report |
| title_full_unstemmed | Left subclavian artery malperfusion due to thoracic outlet syndrome during total vertebrectomy for invasive lung cancer: a case report |
| title_short | Left subclavian artery malperfusion due to thoracic outlet syndrome during total vertebrectomy for invasive lung cancer: a case report |
| title_sort | left subclavian artery malperfusion due to thoracic outlet syndrome during total vertebrectomy for invasive lung cancer a case report |
| topic | Artery malperfusion Interarm pressure difference Thoracic outlet syndrome Prone position Total vertebrectomy |
| url | http://link.springer.com/article/10.1186/s40981-017-0131-4 |
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