Severe complex regional pain syndrome type II after radial artery harvesting

The radial artery is increasingly used as a coronary bypass graft. We report on a patient who developed a severe complex regional pain syndrome type II—also called causalgia—after radial artery harvesting. After an odyssey of diagnostic and presumed therapeutic procedures, she underwent surgical revision of the left forearm. Intraoperatively, a titanium clip in close neighborhood to the superficial radial nerve affecting the perineurium was found and removed, and more distally, a small neurinoma (3 by 4 mm) was resected. Despite presumed successful operation, symptoms did not improve. The patient presumably remains unable to use her left arm and hand.