Manual Brachial Artery Compression as an Adjunct for Intraoperative Hemostasis During Carpal Tunnel Release
- 1Department of Neurosurgery, St. Marianna University School of Medicine, Kawasaki, Japan
- 2Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
Abstract
BACKGROUND AND OBJECTIVES:: Carpal tunnel release (CTR) is typically a straightforward procedure, and major bleeding is uncommon. However, minor oozing may occasionally interfere with visualization during critical steps. We describe a simple adjunctive maneuver using manual brachial artery compression for temporary control of arterial inflow during CTR.
METHODS:: This retrospective study describes a consecutive series of 55 patients who underwent CTR under local anesthesia with epinephrine. Manual compression of the brachial artery was applied intermittently to modulate arterial inflow during critical surgical steps. Operative findings and postoperative complications were evaluated. Intraoperative discomfort was retrospectively assessed from nursing records. In a subset of 26 cases with operative video recordings, compression duration and intraoperative bleeding control were evaluated using video review and a 5-point Likert scale by 2 surgical team members.
RESULTS:: Manual brachial artery compression was applied without interrupting the surgical workflow and provided temporary control of arterial inflow during critical surgical steps. Among the 26 video-analyzed cases, the median total compression time was 23 minutes (range, 13-38 minutes) and the median maximum continuous compression interval was 13 minutes (range, 8-23 minutes). No evaluations were rated ≤3 on the 5-point Likert scale by either evaluator. No documented intraoperative discomfort, distal ischemia, vascular injury, postoperative hematoma, or other complications were identified.
CONCLUSION:: Manual brachial artery compression is a simple and reproducible adjunctive maneuver that may be useful for temporary control of bleeding during CTR when additional intraoperative hemostatic control is desired.
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BibTeX
@article{yazaki2026manual,
title = {{Manual Brachial Artery Compression as an Adjunct for Intraoperative Hemostasis During Carpal Tunnel Release}},
author = {Sora Yazaki and Mitsuru Sato and Masashi Uchida and Hiroshi Takasuna and Takashi Matsumori and Yuichiro Kushiro and Gaku Hidaka and Takahiro Tanaka and Ryutaro Fukuyama and Kumi Tenjin and Hidetoshi Murata},
journal = {Neurosurgery Practice},
year = {2026},
month = nov,
doi = {10.1227/neuprac.0000000000000321},
url = {https://doi.org/10.1227/neuprac.0000000000000321},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Manual Brachial Artery Compression as an Adjunct for Intraoperative Hemostasis During Carpal Tunnel Release
AU - Sora Yazaki
AU - Mitsuru Sato
AU - Masashi Uchida
AU - Hiroshi Takasuna
AU - Takashi Matsumori
AU - Yuichiro Kushiro
AU - Gaku Hidaka
AU - Takahiro Tanaka
AU - Ryutaro Fukuyama
AU - Kumi Tenjin
AU - Hidetoshi Murata
PY - 2026
DA - 2026/11/05
JO - Neurosurgery Practice
DO - 10.1227/neuprac.0000000000000321
UR - https://doi.org/10.1227/neuprac.0000000000000321
AB - BACKGROUND AND OBJECTIVES:: Carpal tunnel release (CTR) is typically a straightforward procedure, and major bleeding is uncommon. However, minor oozing may occasionally interfere with visualization during critical steps. We describe a simple adjunctive maneuver using manual brachial artery compression for temporary control of arterial inflow during CTR. METHODS:: This retrospective study describes a consecutive series of 55 patients who underwent CTR under local anesthesia with epinephrine. Manual compression of the brachial artery was applied intermittently to modulate arterial inflow during critical surgical steps. Operative findings and postoperative complications were evaluated. Intraoperative discomfort was retrospectively assessed from nursing records. In a subset of 26 cases with operative video recordings, compression duration and intraoperative bleeding control were evaluated using video review and a 5-point Likert scale by 2 surgical team members. RESULTS:: Manual brachial artery compression was applied without interrupting the surgical workflow and provided temporary control of arterial inflow during critical surgical steps. Among the 26 video-analyzed cases, the median total compression time was 23 minutes (range, 13-38 minutes) and the median maximum continuous compression interval was 13 minutes (range, 8-23 minutes). No evaluations were rated ≤3 on the 5-point Likert scale by either evaluator. No documented intraoperative discomfort, distal ischemia, vascular injury, postoperative hematoma, or other complications were identified. CONCLUSION:: Manual brachial artery compression is a simple and reproducible adjunctive maneuver that may be useful for temporary control of bleeding during CTR when additional intraoperative hemostatic control is desired.
SN - 2834-4383
ER -