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Richard E. Welling, MD; John J. Cranley, MD; Raymond J. Krause, MD; Charles D. Hafner, MD

Arch Surg. 1981;116(12):1593-1596.

Abstract
• During the past 20 years, 163 patients had 194 operations for obliterative arterial disease of the upper extremity. Of these, 68 had neurological symptoms primarily that were associated with arterial obstruction of the first portion of the subclavian artery. The remaining 95 patients had ischemic symptoms of the upper extremity, namely, intermittent claudication of the arm or ischemic necrosis of the fingers. There were 95 procedures performed on 90 patients with diminished or absent brachial blood pressures. There were 89 cervical sympathectomies performed on patients whose brachial pressures were equal to the contralateral arm. When sympathectomy was done, results were excellent in patients who had a rise in skin temperature confirmed preoperatively by reflex vasodilation studies. An aggressive approach with early diagnostic arteriography and appropriate surgical therapy is indicated in patients with ischemia to the upper extremity.

(Arch Surg 1981;116:1593-1596)

Author Affiliations
From the Departments of Surgery (Drs Welling, Cranley, Krause, and Hafner) and Medical Education (Dr Cranley), and the Vascular Laboratory (Dr Cranley), Good Samaritan Hospital, and the University of Cincinnati Medical Center (Dr Welling), Cincinnati.

Footnotes
Accepted for publication July 13, 1981.

Read at the 29th scientific meeting of the International Cardiovascular Society, Dallas, June 12, 1981.

Reprint requests to 311 Howell Ave, Cincinnati, OH 45220 (Dr Welling).

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