TNF and ischemia: In the second case, compartment syndrome developed following the removal of an arterial line. Luis and Ng [17] suggested that three primary factors significantly contribute to the disease process: 1) activation of the complement pathway due to arterial cannulation breaching the endothelium; 2) lymphokines such as TNF and IL-1, which activate both the intrinsic and extrinsic coagulation pathways while reducing fibrinolytic activity, leading to vessel thrombosis; and 3) hemodynamic factors, including turbulence, ischemia, and increased venous pressure.