Korean J Thorac Cardiovasc Surg.  2015 Aug;48(4):246-251. 10.5090/kjtcs.2015.48.4.246.

Upper Limb Ischemia: Clinical Experiences of Acute and Chronic Upper Limb Ischemia in a Single Center

• Bae M
• Chung SW
• Lee CW
• Choi J
• Song S
• Kim SP

• KMID: 2382267
• DOI: http://doi.org/10.5090/kjtcs.2015.48.4.246

Abstract

BACKGROUND
Upper limb ischemia is less common than lower limb ischemia, and relatively few cases have been reported. This paper reviews the epidemiology, etiology, and clinical characteristics of upper limb ischemia and analyzes the factors affecting functional sequelae after treatment.
METHODS
The records of 35 patients with acute and chronic upper limb ischemia who underwent treatment from January 2007 to December 2012 were retrospectively reviewed.
RESULTS
The median age was 55.03 years, and the number of male patients was 24 (68.6%). The most common etiology was embolism of cardiac origin, followed by thrombosis with secondary trauma, and the brachial artery was the most common location for a lesion causing obstruction. Computed tomography angiography was the first-line diagnostic tool in our center. Twenty-eight operations were performed, and conservative therapy was implemented in seven cases. Five deaths (14.3%) occurred during follow-up. Twenty patients (57.1%) complained of functional sequelae after treatment. Functional sequelae were found to be more likely in patients with a longer duration of symptoms (odds ratio, 1.251; p=0.046) and higher lactate dehydrogenase (LDH) levels (odds ratio, 1.001; p=0.031).
CONCLUSION
An increased duration of symptoms and higher initial serum LDH levels were associated with the more frequent occurrence of functional sequelae. The prognosis of upper limb ischemia is associated with prompt and proper treatment and can also be predicted by initial serum LDH levels.

Keyword

Upper extremity; Ischemia; Complication; L-lactate dehydrogenase

MeSH Terms

Angiography
Brachial Artery
Embolism
Epidemiology
Follow-Up Studies
Humans
Ischemia*
L-Lactate Dehydrogenase
Lower Extremity
Male
Prognosis
Retrospective Studies
Thrombosis
Upper Extremity*
L-Lactate Dehydrogenase