Complex Regional Pain Syndrome type I following radial artery cardiac catheterization.

In recent years, catheterization via the radial artery has been introduced as an alternative approach to diagnostic and therapeutic cardiac procedures. Pain in the forearm, presumably as a result of radial artery spasm, is frequently reported, and may continue for some time after termination of the procedure. We report a case of Complex Regional Pain Syndrome with the classical features of this potentially disabling condition, with a thankfully benign outcome. A 50-year-old man underwent cardiac catheterization for unstable angina. He had an unremarkable past medical history, with the exception that a year previously, he had also been catheterized (femoral approach) for similar symptoms and was found to have mildly ectatic coronary arteries. On this admission, he was catheterized via the right radial artery after performing the Allen test. A 6F sheath was placed in the right radial artery and mild ectasia of the left anterior descending artery was demonstrated on angiography. The procedure was uneventful except for the appearance of mild right forearm pain during the catheterization. The sheath was removed and hemostasis was performed using local pressure. The pain in the forearm progressively worsened, unrelieved by rest, with the addition of extensive swelling, allodynia and coldness, cyanosis and hyperhidrosis. The radial pulse was ade-