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Aneurysms of the Upper Extremity

Discussion

  • pulsatile, tender mass
  • vasospastic symptoms (burns's)
  • digit ischemia and/or gangrene
  • embolic showers from mural thrombi
  • adjacent nerve compression
  • may be erythematous and mimic an abscess
  • systolic bruit or thrill

Exam

  • allen's test may be positive if the aneuysm is occluded;
  • perform digital Allen's test;

Treatment

  • surgery recommended due to risk of thrombosis & peripheral emb.
  • reconstruction versus resection;
  • choice guided by adequacy of digital blood flow after resection;
  • if DBI >, no reconstuction required