Upper extremity gangrene: a complication of subclavian artery division

Gangrene of the upper extremity is a rare complication following subclavian artery ligation. Two case reports from the 23-year experience at the Hospital for Sick Children are presented. If gangrene is to be eliminated in such cases, early recognition of inadequate limb perfusion is mandatory. A suspicion of inadequate perfusion justifies heparin therapy, and prompt revascularization and fasciotomy must be considered.