Ferşat KOLBAKIR, Atilla SARAC, Muzaffer BAHÇİVAN, Onur DOYURGAN, M. Kemal DMİRAĞ, Tahsin KEÇELİGİL

Thromboembolic occlusion of upper extremity arteries

Background: We evaluated the thromboembolic arterial occlusion of upper extremity and discussed the current treatment methods. Methods: Between January 1984 and January 2006, a total of 184 patients (103 males, 81 females; mean age 62.2±12.6 years; range 6 to 83 years) that were admitted with pain, cyanosis, coldness and loss of function of upper extremity were evaluated retrospectively. The earliest and latest time of admission were four hours and eight days, respectively, and mean time was 28 hours. The arterial occlusion was on the right upper extremity in 111 cases, it was on the left side in 73 cases, and it was bilateral in two cases. Results: Embolectomy was necessary in half of 24 patients who were treated medically. Eight patients received systemic thrombolytic therapy but three of them needed surgical embolectomy. Other 150 patients underwent embolectomy. Re-embolectomy was done for 23 cases as a result of recurrent ischemia. One hundred fourty two patients were dis¬charged without any complication. Hospital mortality and amputation rates were 6.0% and 4.34%, respectively. Conclusion: Different from the chronic occlusions of upper extremity arterial system, acute thromboembolic arterial occlusions may cause loss of extremity. But, early diagnosis and treatment methods help us to reach minimum morbidity and mortality rates. In addition, the investigation of etiologic factors and application of prophylactic methods will decrease the risk of embolic occlusion.

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1. Yao JS. Upper extremity occlusive disease. In: Greenfield LJ, editor. Essentials of surgery: scientific principles and practice. Philadelphia: Lippincott-Raven; 1997. p. 594-600.
2. Hernandez-Richter T, Angele MK, Helmberger T, Jauch KW, Lauterjung L, Schildberg FW. Acute ischemia of the upper extremity: long-term results following thrombembolectomy with the Fogarty catheter. Langenbecks Arch Surg 2001; 386:261-6.
3. Bahçivan M, Demirağ MK, Keçeligil HT, Saraç A, Karamustafa H, Yücel SM, ve ark. İatrojenik damar yaralanmaları. Göztepe Tıp Dergisi 2005;20:38-41.
4. Erentuğ V, Mansuroğlu D, Bozbuğa NU, Erdoğan HB, Elevli MG, Bal E ve ark. Akut arteriyel tıkanıklarda cerrahi tedavi. Türk Göğüs Kalp Damar Cer Derg 2003;11:236-9.
5. Eskandari M, Yao JST, Pearce WH. Upper extremity occlu sive disease. Available from: http://www.emedicine.com/ med/topic2776.htm.
6. Yavuz Ş, Vural H, Eriş C, Türk T, Özdemir A. Periferik arteriyel embolilerinde kardiyak risk faktörleri ve tedavi yaklaşımı. Damar Cer Derg 1998;1:13-7.
7. Taviloğlu K, Günay K, Asoğlu O, Dilege Ş, Kurtoğlu M. 10 yıllık periferik arteriyel tıkanıklık olgularımızın analizi. Damar Cer Derg 1995;4:17-21.
8. Khalil IM, Hoballah JJ. Late upper extremity embolic com plications of occluded axillofemoral grafts. Ann Vasc Surg 1991;5:375-80.
9. Bandyk DF, Thiele BL, Radke HM. Upper-extremity emboli secondary to axillofemoral graft thrombosis. Arch Surg 1981;116:393-5.
10. Saraç A, Akan H, Demirağ MK, Keçeligil HT, Bahçıvan M, Kolbakır F. Akut atardamar tıkanıklıklarında lokal trombo litik tedavi. OMÜ Tıp Dergisi 2004;21:78-83.
11. Fogarty TJ, Cranley JJ, Krause RJ, Strasser ES, Hafner CD. A method for extraction of arterial emboli and thrombi. Surg Gynecol Obstet 1963;116:241-4.