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A case of complex regional pain syndrome type II after transradial coronary intervention

Nobuko Sasano1, Takako Tsuda, Hiroshi Sasano

  • 1Department of Anesthesiology and Medical Crisis Management, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi Mizuho-cho, Mizuho-ku, Nagoya 467-8622, Japan.

Journal of Anesthesia
|November 19, 2004
PubMed

Insights

Transradial coronary intervention is generally safe, but can rarely cause complex regional pain syndrome type II (CRPS type II). This condition involves severe hand pain and disability, requiring prompt medical attention.

Area of Science:

  • Cardiology
  • Neurology
  • Pain Medicine

Background:

  • Transradial approach is a standard technique for coronary catheterization.
  • It is generally associated with minimal complications at the puncture site.

Observation:

  • A 61-year-old woman developed severe right hand pain after transradial coronary intervention for unstable angina.
  • Pain followed the median nerve distribution, and nerve conduction studies suggested carpal tunnel syndrome.

Findings:

  • The patient was diagnosed with complex regional pain syndrome type II (CRPS type II).
  • Treatment included stellate ganglion and cervical epidural blockades, amitriptyline, and loxoprofen.
  • The patient showed gradual symptom improvement and enhanced daily living activities.

Implications:

  • Transradial coronary intervention may lead to serious regional pain and disability, such as CRPS type II.
  • Median nerve damage due to local compression and ischemia is a potential cause.
  • Medical personnel should be vigilant for CRPS type II and avoid excessive compression during the procedure.

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