Acute right brachial artery embolism after left upper division segmentectomy with suspected pulmonary vein stump...

Systemic arterial embolism is an uncommon but potentially serious complication after lung resection. A 63-year-old woman underwent thoracoscopic left upper division segmentectomy for lung adenocarcinoma. On postoperative day (POD) 2, she developed sudden pain, numbness, and weakness of the right upper limb. Bedside ultrasonography showed right brachial artery occlusion, and contrast-enhanced computed tomography (CT) confirmed a distal brachial artery filling defect. A small filling defect was also observed at the pulmonary vein stump, but the embolic source could not be established. Emergency thrombectomy using a Fogarty catheter restored arterial perfusion ~4 h after symptom onset, followed by anticoagulation. Contrast-enhanced CT on POD 28 showed resolution of the pulmonary vein stump filling defect, and no recurrent embolism or bleeding occurred during 3 months of follow-up. This case highlights that sudden upper-limb symptoms after left upper division segmentectomy should prompt immediate vascular assessment, timely revascularization, and evaluation of possible embolic mechanisms.