Compartment Syndrome Complication of Coronary Intervention Using Ulnar Artery Access.

BACKGROUND

Compartment syndrome (CS) is a rare complication from ulnar artery access for coronary intervention.

CASE SUMMARY: An 84-year-old patient presented with acute coronary syndrome. Coronary intervention was performed using ulnar artery access after radial access was found to be unsuitable. Post-procedure, upper extremity hematoma progressed to CS. Surgical fasciotomy and ulnar artery repair was successful, but neurologic impairment remained.

DISCUSSION: This patient represents a unique case of coronary intervention using ulnar artery access with resultant complications of hematoma and progression to CS. In this case, the multitude of vascular risk factors probably contributed to this complication. Early CS recognition by symptoms and examination was assisted by vascular ultrasound. Prompt surgical intervention with evacuation of the hematoma and arterial repair prevented tissue necrosis or possible amputation; however, lingering nerve damage remained.

TAKE-HOME MESSAGE: Early recognition and appropriate management of ulnar artery-related CS is critical to minimize long-term complications.