Welling R E, Cranley J J, Krause R J, Hafner C D
Arch Surg. 1981 Dec;116(12):1593-6. doi: 10.1001/archsurg.1981.01380240073012.
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.
在过去20年中，163例患者因上肢闭塞性动脉疾病接受了194次手术。其中，68例主要有神经症状，与锁骨下动脉第一部分的动脉阻塞有关。其余95例患者有上肢缺血症状，即手臂间歇性跛行或手指缺血性坏死。对90例肱动脉血压降低或消失的患者进行了95次手术。对肱动脉血压与对侧手臂相等的患者进行了89次颈交感神经切除术。当进行交感神经切除术后，术前通过反射性血管扩张研究证实皮肤温度升高的患者效果极佳。对于上肢缺血的患者，建议采取积极的方法，早期进行诊断性动脉造影并进行适当的手术治疗。
