Abstract Details

Title Clinical, Electrodiagnostic, and Radiographic Features of Patients with Brachial Plexopathy following Axillary Artery Cannulation

Topic Neuromuscular and Clinical Neurophysiology (EMG)

Presentation(s) P4 - Poster Session 4 (8:00 AM-9:00 AM)

Poster/Presentation
Number 11-004

Objective To describe the findings and prognosis of brachial plexopathies following axillary artery cannulations for cardiac interventions.

Background Axillary artery cannulations may injure the brachial plexus. A detailed description of these cases and their prognosis would provide insight into understanding the possible mechanisms of injury, and treatment options.

Design/Methods

We reviewed the charts of five patients referred to our electrodiagnostic (EDX) laboratory since 2020 with a diagnosis of brachial plexopathy following axillary artery cannulation.

Results All 5 patients were male, mean age of 40.8 years. Four had a right axillary artery access and one a left axillary artery access. Their cardiac diagnosis and procedures were respectively: acutely decompensated heart failure requiring left ventricular assisting device placement (2 patients), aortic root dissection requiring aortic root repair (1 patient), congenital aortic stenosis requiring aortic valve replacement (1 patient), and mitral regurgitation requiring robotic assisted valve repair (1 patient). Their symptoms were: weakness (5 patients), sensory loss (3 patients), pain (2 patients). Based on neurological examination and electromyography, the lateral cord was injured in all the patients, with one patient also having a medial cord injury, and another one an upper trunk injury. Three patients had an MRI of the brachial plexus; they all showed imaging abnormalities involving the brachial plexus matching the clinical/EDX diagnosis, with one of them showing an axillary artery pseudoaneurysm. Three patients had spontaneous clinical improvement, with one of them showing improvement on EDX as well. Another patient had a spinal cord stimulator placed with significant improvement in pain. The remaining patient has not improved and is awaiting a follow up evaluation.

Conclusions In brachial plexopathies due to axillary artery cannulation, the lateral cord is commonly affected. EDX and MRI of the plexus findings correlate well and are complimentary. Prognosis appears to be good and follow up examinations can help direct specific interventions.

Authors/Disclosures
Andres De Leon, MD (Emory University) PRESENTER	Dr. De Leon Benedetti has nothing to disclose.
Rocio C. Garcia Santibanez, MD, FAAN	Dr. Garcia Santibanez has nothing to disclose.
	No disclosure on file
	No disclosure on file
Nicholas Boulis	Nicholas Boulis has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UCB. Nicholas Boulis has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neurogene. Nicholas Boulis has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sio Gene Therapy. Nicholas Boulis has received personal compensation in the range of $500-$4,999 for serving as a Consultant for PTC. Nicholas Boulis has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BlueRock. Nicholas Boulis has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for CODA Bio. Nicholas Boulis has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Gibbs Attorneys. Nicholas Boulis has received stock or an ownership interest from Curative. Nicholas Boulis has received stock or an ownership interest from Remotor. The institution of Nicholas Boulis has received research support from NIH. Nicholas Boulis has received intellectual property interests from a discovery or technology relating to health care. Nicholas Boulis has received intellectual property interests from a discovery or technology relating to health care. Nicholas Boulis has received intellectual property interests from a discovery or technology relating to health care. Nicholas Boulis has received intellectual property interests from a discovery or technology relating to health care. Nicholas Boulis has received publishing royalties from a publication relating to health care.
Vita Kesner, MD, PhD, FAAN (Emory University)	Dr. Kesner has nothing to disclose.

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