[Arterial surgery of the upper limb].

Area of Science:

• Vascular Surgery
• Upper Extremity Revascularization
• Peripheral Arterial Disease

Context:

• Arterial surgery of the upper limb constitutes a small but significant portion of peripheral vascular procedures.
• A retrospective review of 58 procedures in 45 patients from 1976 to 1989.
• Patients were categorized by etiology: trauma, acute non-traumatic ischemia, and chronic ischemia.

Purpose:

• To evaluate the outcomes of surgical interventions for various etiologies of upper limb arterial disease.
• To analyze the efficacy of different surgical techniques including angioplasty, anastomosis, bypass, ligation, and thrombectomy.
• To assess the overall success rates, mortality, and amputation rates associated with these procedures.

Summary:

• 16 patients with arterial trauma (blunt, penetrating, iatrogenic) showed excellent outcomes (93%) with angioplasty, anastomosis, bypass, ligation, or thrombectomy.
• 16 patients with acute non-traumatic ischemia, primarily due to cardiac emboli, had a high mortality (31%) despite thromboembolectomy.
• 13 patients with chronic ischemia, mostly subclavian artery related, achieved good results (78%) with bypass or endarterectomy.

Impact:

• Overall, 90% of surviving patients experienced satisfactory results, with an 11.1% operative mortality and 13% amputation rate.
• The study highlights the effectiveness of arterial reconstruction for upper limb ischemia, while underscoring the risks associated with acute embolic events.
• Findings provide valuable insights into managing upper limb arterial pathologies and optimizing surgical strategies.