Seegobin Karan, Lyons Brittany, Maharaj Satish, Baldeo Cherisse, Reddy Pramod, Cunningham James
Department of Internal Medicine, University of Florida College of Medicine, Jacksonville, FL 32209, USA.
Department of Interventional Radiology, University of Florida College of Medicine, Jacksonville, FL 32209, USA.
Case Rep Vasc Med. 2017;2017:7461082. doi: 10.1155/2017/7461082. Epub 2017 Jul 10.
To present a case of bilateral brachial artery disease presenting with features of Raynaud's phenomenon which was successfully treated with angioplasty and stenting, together with a review of the relevant literature.
A 71-year-old female presented with a one-year history of intermittent pallor of both hands precipitated with cold objects. On examination, bilateral radial pulses were reduced. Prior photos showed pallor of the distal aspect of both palms. Angiogram showed high grade stenosis of the right brachial artery and focal occlusion with likely dissection of the left brachial artery. She underwent angioplasty and stenting for both lesions. She was asymptomatic without further episodes of Raynaud's phenomenon after five months on dual antiplatelet therapy. Upper-extremity vascular stenosis is uncommon. Structural changes in the vessel wall can cause vasospastic attacks, a mechanism described in secondary Raynaud's phenomenon. We hypothesize that these attacks may have been precipitated by the bilateral brachial artery disease. Furthermore, resolution of the symptoms after stent further supports our theory.
Bilateral brachial artery disease is uncommon. Physicians should consider this in patients presenting with Raynaud's phenomenon. Brachial artery stenosis and occlusion is a treatable disease with good symptomatic outcomes after angioplasty and stenting.
报告一例表现为雷诺现象的双侧肱动脉疾病病例，该病例经血管成形术和支架置入术成功治疗，并对相关文献进行综述。
一名71岁女性，有双手间歇性苍白病史1年，遇冷诱发。检查发现双侧桡动脉搏动减弱。既往照片显示双侧手掌远端苍白。血管造影显示右肱动脉高度狭窄，左肱动脉局灶性闭塞，可能存在夹层。她接受了针对这两处病变的血管成形术和支架置入术。在接受双联抗血小板治疗5个月后，她无症状，未再出现雷诺现象发作。上肢血管狭窄并不常见。血管壁的结构改变可导致血管痉挛发作，这是继发性雷诺现象中描述的一种机制。我们推测这些发作可能是由双侧肱动脉疾病引起的。此外，支架置入后症状缓解进一步支持了我们的理论。
双侧肱动脉疾病并不常见。医生在诊治出现雷诺现象的患者时应考虑到这一情况。肱动脉狭窄和闭塞是一种可治疗的疾病，血管成形术和支架置入术后症状改善良好。
