A Case Report of Intraoperative Brachial and Cerebral Embolization During Pneumonectomy for Lung Cancer

Hypercoagulability in lung cancer has been well described, but multiple arterial emboli are uncommon complications of pneumonectomy. A 59-year-old man underwent a pneumonectomy for squamous cell lung cancer and an intraoperative brachial artery embolism was diagnosed after an abrupt loss of pulse oximeter signal and arterial line waveforms. A cerebral embolization, manifested as a unilateral motor deficit, was noted during the emergence from anesthesia. We hypothesize that thrombus formation within the pulmonary venous system may have been causative. Anesthesiologists should promptly recognize and treat the rare possibility of multiple arterial embolizations during lung cancer surgery.