Arterial embolus to the upper limb

Champion, Howard R.; Gill, William J.

doi:10.1002/bjs.1800600702

Cited by 29 publications

(11 citation statements)

References 23 publications

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“…We agree with those authors who consider preoperative angiography not useful for clinical definition of the diagnosis and unnecessary for localization of the embolus, since in all cases of surgical treatment, the Fogarty balloon catheter renders preoperative localization of the occlusion less important. [2][3][4]10 On the basis of our study and experience we recommend performing preoperative angiography only in very selective cases: recurrent embolizing disease and when other pathology is suspected (sensory, motor disturbances), with previous chronic limb ischemia.…”

Section: Discussionmentioning

confidence: 94%

“…1-3,5-7 Brachial artery embolism has been recorded in 6 % -8 % of all peripheral emboli and is often seen in patients with multiple emboli to other arteries . [2][3][4]6,7 Why do arteries in the upper extremity get fewer emboli than the other arteries of the body? The comparative infrequency of upper limb emboli is probably due to anatomic factors.…”

Section: Discussionmentioning

confidence: 99%

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Acute Brachial Artery Occlusion — Diagnosis and Treatment

1989

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Over a ten-year period 28 patients with brachial emboli were treated. Twenty-five underwent embolectomy under local or regional brachial plexus block using the Fogarty technique within twenty-four hours of onset of symptoms. Reembolectomy was required and performed successfully in 3 of these patients. Pulses were well restored in 20 of the 25. Three patients were treated conservatively. In 1 of these, chronic upper limb disability was observed. High average age and underlying heart disease are common factors in this pathology. The authors' treatment of choice for such patients is surgical embolectomy under local or regional anaesthesia. A high index of suspicion and early definitive surgery can optimize the chance of good results in these patients. One-year follow-up of 22 patients showed functioning upper extremity in all but the 1 conservatively treated patient with chronic upper limb disability.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Acute Brachial Artery Occlusion — Diagnosis and Treatment

1989

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“…In the first case above with chronic trauma of a mainline artery, technically poor reconstruction and delay should have been avoided. Chronic arterial injury with the development of an arterio-venous fistula ,highlighted in case 2., illustrates the distal ischaemia that can result from shunting caused by fistulation as occurs sometimes, even in iatrogenic constructions for vascular access 9. Likewise upper limb embolism, formerly managed conservatively 10 is now thought to need a more active approach to avoid ischaemic symptoms like claudication, loss of delicacy of hand movements , and the loss of sensitivity of the digits especially if the dominant limb is involved 11 .…”

Section: Discussionmentioning

confidence: 99%

Patterns of chronic ischaemia of the upper limbs in the central province of Sri Lanka

et al. 2018

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“…Despite analogical etiopathogenesis, the group of patients with acute arterial occlusions of the vessels of the arm (AAOVA) stands out with its clinical course, as well as with better results concerning mortality and percentage of amputation. [5][6][7][8][9] In this paper we present the results obtained in 200 consecutive patients treated surgically for AAOVA during the seventy-sixmonth period of January, 1985, to May, 1991, at the Vascular Surgery Clinic of the Medical University, Plovdiv, Bulgaria.…”

Section: Introductionmentioning

confidence: 99%

A Surgical Overview of 200 Patients with Acute Arterial Occlusions of the Vessels of the Arm

Kirov

Zakhariev

1993

Vascular Surgery

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Two hundred patients (103 men, 97 women, average age sixty-three years) with acute arterial occlusion of the vessels of the arm (AAOVA) were treated surgically in the period from January, 1985, to May, 1991 70.5% of the occlusions were due to emboli and 29.5% were due to primary thrombosis. The subclavian/axillary arteries were occluded in 29% of the cases, the brachial artery in 59%, and the radial/ulnar arteries in 12%; 77.6% of the subclavian/axillary obstructions were due to emboli and 22.4 to thrombosis, 72.9% of the brachial obstructions were due to emboli and 27.1% to thrombosis, and 41.7% of the radial/ulnar obstructions were due to emboli and 58.3% to thrombosis.Local anesthesia was employed for all patients. There were 49 reoperations: 27 for rethrombosis, 8 for reembolization, 9 for evacuation of hematomas or control of hemorrhage, and 5 for treatment of infection; 11 fasciotomies were performed. Ten (5%) of the patients died, primarily because of cardiac failure or strokes. In 169 patients (84.5%) one or both distal pulses were restored at the wrist with return of normal extremity function. In 22 patients (11%), distal pulses were not restored but the clinical results were satisfactory. In 9 patients (4.5%), amputation at various levels was necessary owing to delayed presentation for treatment, extended thrombosis, or poor vascular status.

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Arterial embolus to the upper limb

Abstract: Seven cases of arterial embolus to the upper limb are presented. The cases support the current trend to management by embolectomy and the restoration of normal hand function as an important feature.

Cited by 29 publications

References 23 publications

Acute Brachial Artery Occlusion — Diagnosis and Treatment

Acute Brachial Artery Occlusion — Diagnosis and Treatment

Patterns of chronic ischaemia of the upper limbs in the central province of Sri Lanka

A Surgical Overview of 200 Patients with Acute Arterial Occlusions of the Vessels of the Arm

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