title: Chronic upper extremity ischemia: current concepts in management.
abstract: As a rule, the few innominate or subclavian obstructions that are symptomatic produce neurologic and extremity symptoms that are easily reversed by an extrathoracic surgical approach. Balloon angioplasty is seeing some utility for this problem also. Concomitant carotid disease may be more significant in that its correction may not only prevent stroke but also mitigate symptoms of subclavian steal. The reconstruction of lesions distal to the vertebral artery frequently results in dramatic and durable improvement. Sympathectomy has a valuable role to play in those cases in which restoration of perfusion cannot be complete.
mesh_terms: D000800:Angioplasty, Balloon; D001013:Aorta, Thoracic; D001132:Arm / Q000098:blood supply*; D001161:Arteriosclerosis / Q000209:etiology / Q000628:therapy; D001366:Axillary Artery / Q000601:surgery; D001775:Blood Circulation; D001916:Brachial Artery / Q000601:surgery; D016122:Brachiocephalic Trunk / Q000601:surgery; D002339:Carotid Arteries / Q000601:surgery; D004691:Endarterectomy; D006801:Humans; D007511:Ischemia / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D013348:Subclavian Artery / Q000601:surgery; D013901:Thoracic Outlet Syndrome / Q000150:complications; D014711:Vertebral Artery / Q000503:physiopathology / Q000601:surgery