Zimmerman N B
Raymond M. Curtis Hand Center, Union Memorial Hospital, Baltimore, Maryland.
Hand Clin. 1993 Feb;9(1):139-50.
Arterial occlusive disease of the upper extremity is most often due to posttraumatic occlusion of the ulnar artery. An embolic source of the ischemia should be considered most strongly when sudden ischemia or vasospasm is associated with atrial fibrillation or follows a myocardial infarction. Connective tissue disorders and several arteridities are infrequent causes of upper-extremity occlusive disease and can usually be detected by a thorough peripheral vascular examination and blood studies. Atherosclerosis of the upper extremity is usually localized to the region of the subclavian artery and can present as a subclavian steal syndrome or arm ischemia. Finally, upper-extremity venous occlusive disease occurs in association with the hypercoagulable state, venous endothelial injury, or arises in otherwise healthy patients because of venous impingement in the thoracic outlet.
上肢动脉闭塞性疾病最常见的原因是尺动脉创伤后闭塞。当突然出现缺血或血管痉挛并伴有心房颤动或发生在心肌梗死后时，应高度怀疑存在缺血的栓子来源。结缔组织疾病和几种动脉炎是上肢闭塞性疾病的罕见病因，通常可通过全面的外周血管检查和血液检查来发现。上肢动脉粥样硬化通常局限于锁骨下动脉区域，可表现为锁骨下动脉窃血综合征或手臂缺血。最后，上肢静脉闭塞性疾病与高凝状态、静脉内皮损伤有关，或者在健康患者中因胸廓出口处静脉受压而发生。
