# Ultrasound Identification of an Atypical Course of the Posterior Intercostal Artery During Paravertebral Block

## TL;DR

This paper describes the use of ultrasound to identify an unusual artery during a paravertebral block, helping avoid vascular injury.

## Contribution

The study highlights an atypical arterial course identified via ultrasound during a paravertebral block procedure.

## Key findings

- An atypical artery was found near the T7-8 paravertebral space during a TPVB.
- Similar arteries were observed one intercostal space above and below the identified area.
- Ultrasound enabled real-time needle visualization, reducing the risk of arterial puncture.

## Abstract

The thoracic paravertebral block (TPVB), while relatively safe, can be associated with significant complications, including inadvertent vascular injury. We describe an ultrasound-guided TPVB where a pulsatile artery was identified between the two transverse processes and in close proximity to the T7-8 paravertebral space, likely the dorsal branch of the posterior intercostal artery. A similar artery was also noted one intercostal space cephalad and caudal of this area. The use of ultrasound allowed for real-time visualization of the needle, minimizing the risk of arterial puncture.