ABSTRACT
The authors report the case of a 34-year old woman with no previous cardiovascular disease who was admitted to hospital for acute ischaemia of the right arm due to embolism, preceded by two episodes of pain and tingling of the left arm related to subacute ischaemia. After right embolectomy, with no possibility of controlateral disobliteration an effective anticoagulation, no cardiac source of embolism could be found; However, transoesophageal echography showed a large mobile thrombus in the aortic arch implanted just before the origin of the left subclavian artery. The only explanation for embolism to the right arm was a retro-oesophageal subclavian artery which was confirmed by scanner. Doppler and arteriography. These investigations, however, did not allow visualisation of the aortic thrombus. In view of the risk of recurrent embolism, a thrombectomy was performed without cardiopulmonary bypass, associated with correction of the vascular abnormality with no complications. This case shows that oesophageal echography is a useful investigation in the work up of acute arterial obstruction in young patients with no cardiac disease.
Subject(s)
Aortic Diseases/complications , Arterial Occlusive Diseases/etiology , Echocardiography, Transesophageal , Ischemia/diagnostic imaging , Subclavian Artery , Thromboembolism/complications , Acute Disease , Adult , Angiography, Digital Subtraction , Aorta, Thoracic , Aortic Diseases/diagnostic imaging , Arm/blood supply , Arterial Occlusive Diseases/diagnostic imaging , Arterial Occlusive Diseases/surgery , Blood Vessel Prosthesis , Female , Follow-Up Studies , Humans , Ischemia/etiology , Ischemia/surgery , Subclavian Artery/abnormalities , Subclavian Artery/surgery , Thrombectomy , Thromboembolism/diagnostic imagingABSTRACT
A case of aneurysm of the ulnar artery, located in the region of the hypothenar eminence is reported. This true traumatic aneurysm had a reconstructive treatment, considering the arterial anatomy of the patient's hand. A resection followed by an end to end anastomosis has been done with a good post-operative result at two years and a half. The unusualness of this pathology, the predominance of its traumatic and occupational etiology are emphasized. True and false traumatic aneurysms are described. The diagnosis of aneurysm is primarily clinical. Arteriography is interesting in the preoperative check-up. Reconstructive surgery is now preferred.
