title: Arterial reconstruction in the upper extremities.
abstract: Arterial reconstruction in the upper extremities is rare relative to the incidence of reconstruction in the lower extremities. Twenty-three patients who underwent vascular reconstruction in the upper extremities from 1985 to 2000 were retrospectively reviewed. Atherosclerosis was observed in only two subclavian arteries. The most common cause of occlusion was thromboembolism from the heart, which occurred often in the brachial artery and could be treated successfully with thrombectomy. Seven of eight bypass grafts, including three procedures below the elbow, remained patent during follow-up periods ranging from 2 to 9 years. Arterial reconstruction of the upper extremities differs from that in the lower extremities. Atherosclerosis is a rare cause of ischemia, and the etiology varies with the site of obstruction. Bypass surgery below the elbow is feasible and successful in selected patients. Ischemia of the upper extremity causes significant morbidity and should be treated aggressively whenever possible.
authors.affiliation: Second Department of Surgery, Yamanashi Medical University, Yamanashi, Japan. sshindo@res.yamanashi-med.ac.jp
authors.forename: Shunya
authors.initials: S
authors.lastname: Shindo
authors.forename: Atsuo
authors.initials: A
authors.lastname: Kojima
authors.forename: Tadao
authors.initials: T
authors.lastname: Ishimoto
authors.forename: Keiji
authors.initials: K
authors.lastname: Iyori
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Tada
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001132:Arm / Q000098:blood supply*; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D005260:Female; D006801:Humans; D007511:Ischemia / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D017131:Thrombectomy; D013923:Thromboembolism / Q000601:surgery; D016896:Treatment Outcome