Thromboembolism of the palmar arch and digital arteries on the background of posttraumatic aneurysm of the left brachial artery

Kabirov A.V., Vasin A.S., Grachev A.M., Panfilov S.D.

Municipal Clinical Hospital No 29 Department of Vascular Surgery, Novokuznetsk, Russia

The present article is aimed at describing a clinical case report associated with thromboembolism of the distal arterial bed of the left upper extremity (the palmar arches of the hand and interdigital arteries) with the development of severe acute ischaemia on the background of a false post-traumatic aneurysm of the left brachial artery. The patient underwent comprehensive treatment including conservative therapy and stagewise operative interventions. As one of the components of conservative therapy was systemic thrombolysis of Actilyse. The first stage of the operative intervention consisted in upper thoracic endoscopic sympathectomy on the left with positive dynamics of the state of soft tissue of the left hand. The second stage was resection of the pseudoaneurysm of the left brachial artery and amputation of the phalanges II-V of the fingers of the left hand.

The mentioned approach made it possible to save the left hand and preserve its grasping function.

KEY WORDS: thromboembolism, distal arterial bed, acute ischaemia, false aneurysm, thromboembolic therapy, thoracic endoscopic sympathectomy, resection of pseudoaneurysm.

P. 151

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