Management of digital emboli, vasospasm, and ischemia in ATOS

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3 Scopus citations

Abstract

Unilateral digital ischemia is one of the most common presenting problems in patients with arterial TOS, leading to numbness, tingling, cold and painful sensations, cyanotic or pale discoloration, delayed capillary refill in the fingers, and non-healing fingertip ulceration. Diagnostic evaluation requires differentiation between proximal and distal arterial sources of thromboembolism, localized digital artery occlusion, and primary vasospasm. Digital emboli typically accompany arterial TOS as a result of mural thrombus formed within an area of aneurysmal degeneration in the subclavian (or axillary) arteries. While there are a variety of medical treatments to help reduce local symptoms of digital ischemia and vasospasm, definitive management depends on surgical control of the proximal source of thromboembolism. Additional interventions, such as thromboembolectomy and intra-arterial infusion of thrombolytic agents and/or vasodilators, are valuable adjuncts toward achieving optimal outcomes.

Original languageEnglish
Title of host publicationThoracic Outlet Syndrome
PublisherSpringer London
Pages557-563
Number of pages7
ISBN (Electronic)9781447143666
ISBN (Print)9781447143659
DOIs
StatePublished - Jan 1 2013

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