Ettien J T
Am Surg. 1980 Apr;46(4):267-9.
Of all upper extremity emboli, 20 per cent arise from an arterial, not cardiac, source. Therefore, one should always consider an arterial source for embolic occlusion of the axillobrachial axis. Chronic axillary crutch use in the patient with acute, noncardiac embolism of the upper extremity should suggest the diagnosis of crutch-induced axillary artery aneurysm. Treatment consists of resection of the aneurysm with reconstruction. Distal embolectomy should also be performed. Forearm fasciotomy and cervicodorsal sympathectomy should be considered in an adjunctive role. In the absence of compelling contraindications, surgical treatment should be offered at the time of discovery of the aneurysm to prevent continued microembolization to the extremity.
在所有上肢栓子中，20%源自动脉而非心脏。因此，对于腋肱轴的栓子闭塞，应始终考虑动脉来源。上肢急性非心脏栓塞患者长期使用腋下拐杖应提示诊断为拐杖所致腋动脉瘤。治疗包括切除动脉瘤并重建。还应进行远端栓子切除术。可考虑辅助性地进行前臂筋膜切开术和颈胸交感神经切除术。在没有明显禁忌证的情况下，发现动脉瘤时应进行手术治疗，以防止肢体持续发生微栓塞。
