Korean J Vasc Endovasc Surg.  2013 Aug;29(3):85-90. 10.5758/kjves.2013.29.3.85.

Clinical Characteristics of Acute Arterial Thromboembolism of Upper Extremity

• Oh CY
• Park YJ
• Yang SS
• Kim DI
• Kim DK
• Kim YW

• KMID: 1464405
• DOI: http://doi.org/10.5758/kjves.2013.29.3.85

Abstract

PURPOSE
To evaluate the clinical characteristics and treatment outcomes of acute upper extremity thromboembolism.
METHODS
From April 1997 to July 2012, nineteen patients (10 males, mean age 69.7 years) were treated for acute upper extremity thromboembolism. Iatrogenic or traumatic acute thromboembolisms were excluded. We retrospectively reviewed patient demographics, clinical characteristics (symptom, risk factor, involved artery, and duration from initial symptom onset to primary treatment) and treatment outcomes.
RESULTS
Numbness or tingling sense was the most common symptom in patients (84.2%). Twelve patients (63.1%) had cardiac arrhythmia, of which 9 patients had atrial fibrillation (47.3%). Floating thrombus was detected on transesophageal echocardiography in 6 patients. Fourteen patients (73.7%) were treated within 24 hours from the symptom onset. Most thromboembolism was located in the brachial artery bifurcation with or without proximal or distal extension. Fogarty catheter thromboembolectomy was the primary treatment in 17 patients (89.5%), of whom 13 patients (72.2%) were operated under local anesthesia. All patients received anticoagulation or antithrombotic therapy after the procedure. Three patients had recurrent thrombosis on duplex scan; however, their symptoms were improved without further intervention. All other patients were symptom-free without recurrence during the mean follow-up of 17.1+/-21.3 months.
CONCLUSION
Early diagnosis and Fogarty catheter thromboembolectomy under local anesthesia followed by proper anticoagulation is the most effective and useful treatment in patients with acute upper extremity thromboembolism.

Keyword

Acute ischemia; Thromboembolism; Upper extremity; Thromboembolectomy

MeSH Terms

Anesthesia, Local
Arrhythmias, Cardiac
Arteries
Atrial Fibrillation
Brachial Artery
Catheters
Demography
Early Diagnosis
Echocardiography, Transesophageal
Follow-Up Studies
Humans
Hypesthesia
Male
Recurrence
Retrospective Studies
Risk Factors
Thromboembolism
Thrombosis
Upper Extremity