Arterial Surgery for Arm Ischemia A Survey of 136 Patients

Abstract

A series of 136 patients with upper extremity ischemia requiring operative correction is presented. Causes of the ischemia included trauma, atherosclerosis, embolism, iatrogenic causes, radiation injury, and cervical rib syndrome. Operations included primary repair, various bypass grafts and embolectomy. Illustrative case reports are used to emphasize important points. The subclavian, axillary and brachial arteries have been considered separately. In general, ischemia of the arm caused by a discrete lesion is amenable to surgical correction with an excellent change of success.

True aneurysm of brachial artery

“…We performed search strategy through Medline and Embase database from 1950 through 2009 using the Dialog Datastar Interface with key words as follows: aneurysm; brachial artery; female; upper extremity; and hand. A total of 21 papers were identifi ed of which eight were deemed to be relevant [19][20][21][22][23][24][25][26].…”

Delayed weakness following a gunshot wound

“…The reason for this is the rich network of collateral circulation around the shoulder. 1 "Pseudoaneurysm'' is the term commonly applied to an aneurysm made up only of the adventitia and lacking the media and intima, the other layers of the arterial wall. 2 Formation of a pseudoaneurysm after trauma often escapes detection, with up to 20% of patients experiencing a considerable delay in diagnosis.…”

Systematic review of the operative and non-operative management of acute upper limb ischemia

“…Systemic complications, such as CVA and cardiac failure, occurred in 7.2% of the patients, and in-hospital mortality was 5.6%. Saveylev et al 5 reported the best results with embolectomy using the anticubital approach Dissecting aneurysm 6,8,11 Small vessel disease 1 Radiation fibrosis 20,35 Hypercoagulable states 20 Inflammatory vasculitides 6,20 Arterial catheterization 13,23 Thoracic outlet obstruction 6 with a 91% success rate in a large study of 256 consecutive patients with a total of 260 AUL emboli treated over a 35-year period. Forty-seven patients were treated conservatively who were either too unfit for interventional treatment or symptomatically mild.…”