Upper extremity ischemia [acute and chronic]

ABSTRACT

88 patients with upper extremity ischemia [acute and chronic] were the subject of this work. They included 3 groups - Acute embolic ischemia [59.1%]. - Arterial non embolic occlusive disease [27.3%]. - Thoracic outlet syndrome [13.6%]. Embolic cases were easily diagnosed, due to the presence of the cardiac cause, and were managed by catheter embolectomy. Arterial occlusive lesions were more commonly due to arteritis [54.2%] than atherosclerosis [45.8%]. For central lesion [innominate and subclavian arteries] extra-thoracic procedure as axillo-axillary and carotid subclavian by passe were prefered over the direct intra-thoracic procedures. Axillobrachial occlusions were manged by saphenous vein by passes. 4 cases were managed conservatively they had very mild ischemic symptoms. Compression of the subclavian artery at the thoracic outlet was managed via the supraclavicular approach, by excision of the stenosed segment and the post stenotic dilatation and prosthetic graft replacement. The results of management was satisfactory