Chronic Upper Extremity Arterial Insufficiency

摘要: • Forty-eight arterial reconstructions were performed for chronic upper extremity ischemia in 43 patients, aged 31 to 81 years. Diagnostic catheterization was the most frequent cause of symptomatic occlusion, followed by proximal arteriosclerotic lesions and noniatrogenic trauma. Doppler ultrasound evaluation provided important diagnostic prognostic data that complemented information derived from arteriography. Indications operation included disabling claudication (39 cases) or digital gangrene (four cases). Restoration normal function can be anticipated except instances where poor forearm runoff exists. Autogenous saphenous basilic interposition vein grafts have proved excellent axillary-brachial revascularizations. Axillary-axillary bypass procedures innominate-subclavian artery occlusions appear hemodynamically sound technically simple. Follow-up, averaging 48 months, extended 144 months. Late graft failure progressive distal occlusive disease not encountered. (Arch Surg113:419-423, 1978)