To the Editor:

We thank Jue and colleagues for presenting their case of compartment syndrome resulting from radial access.1  As they observed, this is a rare sequela of radial artery catheterization, and compartment syndrome is not typically in the differential diagnosis for hand or arm pain after radial access.

We had a similar case. One of our patients underwent diagnostic peripheral angiography via radial access. There were no problems attaining radial artery access or inserting the sheath. Sheath removal was uneventful and without hematoma development. However, upon returning to his room, the patient reported forearm pain and paresthesia. His compartment pressures were elevated. Because of his symptoms, we performed exploratory surgery and fasciotomy. Intraoperatively, there was no evidence whatsoever of bleeding in the forearm, of side-branch arterial injury, or of hematoma. After further investigation, however, we discovered that the patient's forearm intravenous catheter had infiltrated a substantial amount of saline solution before its uncomplicated removal.

We bring this up to point out that the differential diagnosis for compartment syndrome includes intravenous infiltration.2–5 

References

1.
Jue
J
,
Karam
JA
,
Mejia
A
,
Shroff
A.
Compartment syndrome of the hand: a rare sequela of transradial cardiac catheterization
.
Tex Heart Inst J
2017
;
44
(
1
):
73
6
.
2.
Yamaguchi
S
,
Viegas
SF.
Causes of upper extremity compartment syndrome
.
Hand Clin
1998
;
14
(
3
):
365
70
,
viii
.
3.
Ibey
A.
Pediatric compartment syndrome caused by intravenous infiltration
.
Ann Plast Surg
2012
;
69
(
3
):
340
.
4.
Schmit
BM
,
Freshwater
MF.
Pediatric infiltration injury and compartment syndrome
.
J Craniofac Surg
2009
;
20
(
4
):
1021
4
.
5.
Dieter
RS
,
Dieter
RA
Jr
,
Dieter
RA
III
,
Nanjundappa
A
,
editors
.
Critical limb ischemia: acute and chronic
.
Springer International Publishing
Switzerland
;
2017
.

Letters to the Editor should be no longer than 2 double-spaced typewritten pages and should generally contain no more than 6 references. They should be signed, with the expectation that the letters will be published if appropriate. The right to edit all correspondence in accordance with Journal style is reserved by the editors.