eMedicine Specialties > Vascular Surgery > Medical Topics
Upper Extremity Occlusive Disease: Follow-up
Updated: Oct 30, 2009
Outcome and Prognosis
- Carotid-subclavian bypass yields 86-100% 5-year patency.
- Subclavian transposition yields 95-100% 5-year patency.
- Upper extremity bypass yields 52% 5-year patency.
- Arterial reconstruction for thoracic outlet yields 90% 5-year patency.
- Zero to 25% of patients with Raynaud disease with negative serology findings develop a connective-tissue disease, and 11-60% of patients with Raynaud disease with positive serology findings develop a connective-tissue disease.
Future and Controversies
Percutaneous transluminal angioplasty (PTLA), with or without stenting, is used to treat proximal subclavian stenosis. The indications for PTLA of subclavian artery stenosis include vertebrobasilar insufficiency with steal, angina with left internal mammary artery (LIMA) graft, and arm fatigue.
The role of a thoracic or digital artery sympathectomy is controversial in patients with digital gangrene. These patients usually have an underlying connective-tissue disease such as scleroderma; calcinosis, cutis, Raynaud phenomenon, esophageal motility disorder, sclerodactyly, and telangiectasia (components of CREST); or systemic lupus erythematosus (SLE). Either thoracic or digital sympathectomy provides a transient 6-12 months of increased skin perfusion.
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Follow-up: Upper Extremity Occlusive Disease |
| Multimedia: Upper Extremity Occlusive Disease |
| References |
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References
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Further Reading
Keywords
upper extremity occlusive disease, upper extremity arterial disease, atherosclerosis, arteritis, fibromuscular dysplasia, Raynaud syndrome, cold sensitivity, Raynaud disease, subclavian artery stenosis, Takayasu arteritis, subclavian artery disease
Follow-up: Upper Extremity Occlusive Disease