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Ischemia of the fingers after carpal tunnel syndrome treatment
We present a case in which a depot triamcinolone acetonide (Kenacort) was unintentionally injected intra-arterially into the ulnar artery, resulting in microembolic capillary occlusion in the digits supplied by the artery. Ischemic changes and subungual petechial hemorrhages were seen in the ulnar t...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Taylor & Francis
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7006639/ https://www.ncbi.nlm.nih.gov/pubmed/32083150 http://dx.doi.org/10.1080/23320885.2019.1711381 |
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author | Bosma, Niels H. de Jong, Tjeerd R. |
author_facet | Bosma, Niels H. de Jong, Tjeerd R. |
author_sort | Bosma, Niels H. |
collection | PubMed |
description | We present a case in which a depot triamcinolone acetonide (Kenacort) was unintentionally injected intra-arterially into the ulnar artery, resulting in microembolic capillary occlusion in the digits supplied by the artery. Ischemic changes and subungual petechial hemorrhages were seen in the ulnar three digits. Angiography confirmed microembolic occlusion. The patient was treated with systemic vasodilative agents and a brachial plexus blockade. Tissue necrosis did not develop, however, the patient suffered lasting cold intolerance in the affected digits. Steroid suspension particles injected to treat CTS or other indications, can cause capillary occlusion and thereby microembolic tissue ischemia if injected intra-arterially. Choosing the right injection site and aspirating prior to injection is a simple though effective and indispensable measure to help prevent intra-arterial injection of steroid suspensions. |
format | Online Article Text |
id | pubmed-7006639 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Taylor & Francis |
record_format | MEDLINE/PubMed |
spelling | pubmed-70066392020-02-20 Ischemia of the fingers after carpal tunnel syndrome treatment Bosma, Niels H. de Jong, Tjeerd R. Case Reports Plast Surg Hand Surg Case Reports We present a case in which a depot triamcinolone acetonide (Kenacort) was unintentionally injected intra-arterially into the ulnar artery, resulting in microembolic capillary occlusion in the digits supplied by the artery. Ischemic changes and subungual petechial hemorrhages were seen in the ulnar three digits. Angiography confirmed microembolic occlusion. The patient was treated with systemic vasodilative agents and a brachial plexus blockade. Tissue necrosis did not develop, however, the patient suffered lasting cold intolerance in the affected digits. Steroid suspension particles injected to treat CTS or other indications, can cause capillary occlusion and thereby microembolic tissue ischemia if injected intra-arterially. Choosing the right injection site and aspirating prior to injection is a simple though effective and indispensable measure to help prevent intra-arterial injection of steroid suspensions. Taylor & Francis 2020-01-20 /pmc/articles/PMC7006639/ /pubmed/32083150 http://dx.doi.org/10.1080/23320885.2019.1711381 Text en © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Reports Bosma, Niels H. de Jong, Tjeerd R. Ischemia of the fingers after carpal tunnel syndrome treatment |
title | Ischemia of the fingers after carpal tunnel syndrome treatment |
title_full | Ischemia of the fingers after carpal tunnel syndrome treatment |
title_fullStr | Ischemia of the fingers after carpal tunnel syndrome treatment |
title_full_unstemmed | Ischemia of the fingers after carpal tunnel syndrome treatment |
title_short | Ischemia of the fingers after carpal tunnel syndrome treatment |
title_sort | ischemia of the fingers after carpal tunnel syndrome treatment |
topic | Case Reports |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7006639/ https://www.ncbi.nlm.nih.gov/pubmed/32083150 http://dx.doi.org/10.1080/23320885.2019.1711381 |
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