Arterial revascularization for upper extremity ischemia in patients with chronic kidney disease

Jeremy A. Warren, Gautam Agarwal, James J. Wynn

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Surgical revascularization of the upper extremity is uncommon, comprising only 4 to 18 per cent of all vascular surgical interventions. Patients with renal failure have higher rates of atherosclerotic cardiovascular and peripheral arterial disease resulting from chronic inflammation, endothelial damage associated with hemodialysis, and vascular trauma. Upper extremity arterial disease with chronic ischemia may be underrecognized in these patients. We reviewed our experience with upper extremity revascularization in patients with renal failure presenting with chronic ischemia. Four patients with longstanding chronic kidney disease developed chronic severe ischemia affecting the forearm or hand. All had previous dialysis access in the symptomatic arm, although none had a functional ipsilateral access at the time of presentation. All patients had successful revascularization with resolution of symptoms and patent bypass grafts at follow up. There was one death 4 months postoperatively and one patient has not returned for follow up. Patients with renal failure with symptomatic upper extremity arterial occlusion should be considered for revascularization of the infrabrachial arteries.

Original languageEnglish (US)
Pages (from-to)848-852
Number of pages5
JournalAmerican Surgeon
Volume75
Issue number9
StatePublished - Sep 1 2009

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Chronic Renal Insufficiency
Upper Extremity
Ischemia
Renal Insufficiency
Blood Vessels
Peripheral Arterial Disease
Forearm
Renal Dialysis
Dialysis
Arm
Chronic Disease
Hand
Arteries
Inflammation
Transplants
Wounds and Injuries

ASJC Scopus subject areas

  • Surgery

Cite this

Arterial revascularization for upper extremity ischemia in patients with chronic kidney disease. / Warren, Jeremy A.; Agarwal, Gautam; Wynn, James J.

In: American Surgeon, Vol. 75, No. 9, 01.09.2009, p. 848-852.

Research output: Contribution to journalArticle

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