Arch Plast Surg.  2019 Nov;46(6):594-598. 10.5999/aps.2018.01158.

Brachial plexus impingement secondary to implantable cardioverter defibrillator: A case report

• Jumper N
• Radotra I
• Witt P
• Campbell N
• Mishra A

• KMID: 2465561
• DOI: http://doi.org/10.5999/aps.2018.01158

Abstract

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.

Keyword

Brachial plexus; Defibrillators, implantable; Brachial plexus neuropathies

MeSH Terms

Adult
Arm
Brachial Plexus Neuropathies
Brachial Plexus*
Defibrillators*
Defibrillators, Implantable
Female
Fibrosis
Hand
Humans
Hypesthesia
Median Nerve
Muscle Weakness
Neural Conduction
Neuralgia
Prevalence
Subclavian Vein