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KMID : 0904020130290030085
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Journal of Korean Society for Vascular Surgery
2013 Volume.29 No. 3 p.85 ~ p.90
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Clinical Characteristics of Acute Arterial Thromboembolism of Upper Extremity
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Oh Chae-Youn
Park Yang-Jin
Yang Shin-Seok
Kim Dong-Ik
Kim Duk-Kyung
Kim Young-Wook
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Abstract
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Purpose: To evaluate the clinical characteristics and treatment outcomes of acute upper extremity throm-boembolism.
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 symp-tom-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.
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KEYWORD
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Acute ischemia, Thromboembolism, Upper extremity, Thromboembolectomy
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