Key result
Implantable cardioverter defibrillator placement via subclavian vein approach can cause severe partial left brachial plexopathy due to lateral cord impingement by the generator and lead loop.
Why the study?
Complication rates of 9.1% occur after ICD placement, but brachial plexus injury is infrequently reported in the literature.
Case Report (n=1)
Brachial plexus impingement is a rare but important complication of ICD placement that may require surgical neurolysis and device repositioning.
Answers are grounded in this paper and cite their sources.
Brachial plexopathy after subclavian ICD revision warrants clinical awareness; single case leaves open incidence and prevention strategies.
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.
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Jumper et al. (2019) conducted a case report in Brachial plexus impingement secondary to implantable cardioverter defibrillator (n=1). Implantable cardioverter defibrillator (ICD) placement was evaluated on Brachial plexus injury. Implantable cardioverter defibrillator placement via subclavian vein approach can cause severe partial left brachial plexopathy due to lateral cord impingement by the generator and lead loop.
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