Surgery of the arteries supplying the upper limbs

The main arteries supplying the upper limbs are a. axillaris, a. brachialis, a. radialis, and a. ulnaris.

Ischemia HK
Ischemia  is generally a local lack of blood supply to a tissue or an organ, which can lead to its damage and eventually death of the organ - tissue necrosis. Ischemia is primarily caused by a lack of oxygen (so-called hypoxia), followed by a lack of nutrients and the accumulation of harmful substances - waste products.

Acute

 * The source is emboly in the arteries of the upper limbs: ** proximal (a. subclavia, axillaris, brachialis) – sourse in L heart;
 * distal (to the finger arteries) – he source of the bulge on the subclavian artery, or on the intrathoracic branches of the aorta.

Chronic

 * Obliterative:
 * atherosclerosis – changes to the axillo-brachial level;
 * mediocalcinosis – smaller arteries, in diabetics;
 * arteritis – Burger's disease (arteries of fingers and hand), Takayasu's arteritis (subclavian artery);
 * postradiation arteritis – subclavian artery after radiation for mammary carcinoma;
 * thoracic outlet syndrome.
 * Neo-obliteration:
 * Raynaud's disease (vasospasms of finger arteries without a known cause) and Raynaud's phenomenon (known cause - collagenosis, arteritis).

Raynaud's syndrome

 * Causes – collagenosis (skleroderma, SLE) and various arteritis.
 * It requires complex serology – cold agglutinins, rheumatoid factor,complement, ANCA, …
 * Vascular damage is functional without morphological changes, only after years secondary degenerative changes occur (fibrosis of the intima and media, atrophy, ulceration and even gangrene of the fingertips).
 * Clinically paroxysmal whitening of the fingertips (vasospastic stage) on exposure to cold, lasting several minutes to hours, followed by cyanosis and swelling of the fingers (vasoparalytic stage).


 * Therapy - mainly conservative, protection of hands from cold, gloves, no smoking, nifedin.

Digital artery occlusion

 * In addition to Raynaud's, it can cause Bürger's disease or small emboli.

Neurovascular compression (syndrome (upper thoracic aperture syndrome)

 * see below

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