Ischemia of the upper extremity: significance of proximal arterial disease

Abstract

Thirty-four patients had upper extremity ischemia due to proximal arterial disease, including subclavian compression at the thoracic outlet, innominate or subclavian atherosclerosis, and other causes. Nineteen lesions caused distal embolization. Although successful arterial reconstructions were performed in all but one patient, there were five major amputations. Four were associated with a delay in diagnosis, which allowed the formation of repeated distal emboli. Since overlooked proximal brachiocephalic arterial lesions can produce devastating consequences, we believe these vessels should be examined in all cases of hand and arm ischemia.