Upper Limb Ischemia by Subclavian Artery Dissection after Osteopathic Manipulation

Ann Vasc Surg. 2018 Apr:48:251.e15-251.e16. doi: 10.1016/j.avsg.2017.10.010. Epub 2017 Dec 5.

Abstract

We report the case of a young woman who experienced ischemia of upper limb after osteopathic manipulation. Duplex and computed tomography scan showed wall hematoma of the ostium of subclavian artery. The patient spontaneously recovered so that no surgery was necessary. Dissection of vertebral and carotid arteries has been reported after osteopathic manipulations. We report ischemia of upper limb secondary to dissection of subclavian artery. Arterial dissections associated with manipulation should be recorded in a register in order to assess more carefully the vascular risk that this method carries.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anticoagulants / therapeutic use
  • Computed Tomography Angiography
  • Female
  • Hematoma / diagnostic imaging
  • Hematoma / drug therapy
  • Hematoma / etiology*
  • Hematoma / physiopathology
  • Heparin, Low-Molecular-Weight / therapeutic use
  • Humans
  • Iloprost / therapeutic use
  • Ischemia / diagnostic imaging
  • Ischemia / drug therapy
  • Ischemia / etiology*
  • Ischemia / physiopathology
  • Manipulation, Osteopathic / adverse effects*
  • Subclavian Artery / diagnostic imaging
  • Subclavian Artery / drug effects
  • Subclavian Artery / injuries*
  • Subclavian Artery / physiopathology
  • Tinzaparin
  • Treatment Outcome
  • Ultrasonography, Doppler, Color
  • Upper Extremity / blood supply*
  • Vascular System Injuries / diagnostic imaging
  • Vascular System Injuries / drug therapy
  • Vascular System Injuries / etiology*
  • Vascular System Injuries / physiopathology
  • Vasodilator Agents / therapeutic use

Substances

  • Anticoagulants
  • Heparin, Low-Molecular-Weight
  • Vasodilator Agents
  • Tinzaparin
  • Iloprost