Complex Regional Pain Syndrome after Transfemoral Coronary Balloon Angioplasty
We hereby present a case of 55 years old man who developed localized pain, allodynia, hyperdynia and swelling over right ankle joint post coronary balloon angioplasty done through transfemoral access on right side. Bone scan confirmed the diagnosis of complex regional pain syndrome. Physiotherapy and various analgesics were given. This case is the premier presentation of complex regional pain syndrome as the remote post procedural complication of transfemoral coronary balloon angioplasty.
We present a case of 55 years old man who presented to us with post infarct angina in June, 2015. We did coronary angiography which revealed a tight lesion in left anterior descending artery. Patient was prepared for coronary angioplasty with drug eluting stent which was done successfully by taking transfemoral artery approach with seldinger technique. Femoral sheath was removed and bleeding was controlled with manual compression.
Traditionally, femoral sheath is removed 6 hours post procedure and patient is asked to avoid movements of the same leg for next 6 hours. Patient developed compression of superficial peroneal nerve at femoral neck during that steady posture with outward turned right leg.
Complex regional pain syndrome often develops after tissue injury such as minor limb trauma, fractures, myocardial infarction, or stroke. (1) CRPS most commonly affects one limb and symptoms are unrelated to the severity of the initial trauma. It is divided into two types. CRPS type II is a regional pain syndrome that develops after injury to a specific peripheral nerve, often a major nerve trunk while CRPS is not confined to distribution single peripheral nerve.
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