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Successful Palmar Arch Revascularization of Thromboangiitis Obliterans in the Upper Extremity
1Department of Cardiology, Sakarya University, Sakarya, Turkey.
Background:
Thromboangiitis obliterans (TAO) is a nonatherosclerotic vasculitis predominantly affecting young male smokers, commonly involving arteries of the extremities.TAO in the upper extremity presents distinct clinical challenges because of its impact on functionality and the complexity of treatment.
Case Summary:
A 46-year-old man who was a heavy smoker presented with a 6 × 4 cm ulceration on the left hand. Peripheral angiography was performed to confirm the diagnosis and assess the arterial anatomy. After revascularization of radial and ulnar arteries and the palmar arch, blood flow was successfully restored through both the radial and ulnar arteries into the palmar arch.
Discussion:
In this report, we describe a case successfully managed with complete upper extremity revascularization, highlighting the interventional strategy and its clinical outcomes.
Take-Home Messages:
TAO may affect the upper extremities, and there is no definitive treatment for upper extremity involvement. Percutaneous interventions and palmar arch angioplasty help prevent amputation and accelerate wound healing.
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Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above...

