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Case Reports
. 2023 Jan 30;36(3):400-402.
doi: 10.1080/08998280.2023.2167187. eCollection 2023.

Management of a patient with unintended intravenous dihydroergotamine infusion extravasation causing brachial artery vasospasm

Jim Sheng  1 , Callie Ebeling  1
Affiliations
Case Reports

Management of a patient with unintended intravenous dihydroergotamine infusion extravasation causing brachial artery vasospasm

Jim Sheng et al. Proc (Bayl Univ Med Cent). .

Abstract

We present a patient being treated with intravenous dihydroergotamine (DHE) complicated by brachial artery vasospasm secondary to extravasation of DHE from an infiltrated peripheral intravenous catheter. She subsequently developed symptomatic vasospasm of the brachial artery, which ultimately required surgical intervention. Severe vasospasm remains a rare but serious risk of intravenous DHE extravasation, but there is currently limited data on proper management of this complication. This case report documents our management that led to full recovery of the patient. We recommend the use of reliable catheters for DHE infusions and prompt vascular surgery consult if there is suspicion for unintended extravasation.

Keywords: Brachial artery vasospasm; case report; dihydroergotamine extravasation.

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Conflict of interest statement

No funding or potential conflict of interest was reported by the authors. Consent was obtained from the patient for publication of this case.

Figures

Figure 1.
Figure 1.
Right upper extremity of the patient where the infusion catheter had been removed.
Figure 2.
Figure 2.
Intraoperative arteriogram images. (a, b) Section of stenosis within the brachial artery visualized under fluoroscopy. (c) Balloon angioplasty was performed. (d) Following ballooning and intra-arterial injection of nitroglycerin, the area of stenosis was significantly improved.
See this image and copyright information in PMC

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