Tuesday, 6 December 2016

Endovascular Therapy of Critical Upper Limb Ischaemia, Performed Two Months after Thromb-Embolic Occlusion of Axillary to Brachial Artery

A 68 years old female patient, hypertensive, non-diabetic, under medical treatment for clinically diagnosed Ischaemic Heart disease, had sudden onset acute pain in the right arm with development of pallor of the arm and absence of radial pulse detected by her husband. On hospitalization (district level), previously undiagnosed atrial fibrillation was detected on ECG, and no pulse was available distal to the axillary artery. Arterial Doppler examination confirmed thrombotic occlusion of the axillary artery at the level of neck of humerus. 

Critical Upper Limb Ischaemia


Clinical diagnosis was thrombo-embolic occlusion of right axillary artery following development of atrial fibrillation of unknown duration. As per the discharge report from the district hospital, she was treated in intensive care unit with Morphine, Heparin (low molecular0, Clopidogrel and Aspirin. The next morning an angiogram was performed from right femoral artery, confirming the clinical diagnosis in addition to a highly tortuous double U-turn subclsvian artery. She was continued on medical management only and discharged after 7 days under Warfarin, reporting significantly improved condition of the arm. Read more....................

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