CCDS evaluation of the arteries of the upper limbs

  • P. Hübsch
  • S. Trattnig


In contrast to the clinical presentation of stenosis or occlusion in the carotid arteries or arteries of the lower limbs, arterial compromise in the upper extremities is often relatively asymptomatic and occurs less frequently. When symptoms are present they relate both to the location and severity of the lesion and to the degree of muscular exertion in the affected vascular bed. Figure 1 summarizes the major arteries of the upper extremity including their origins and their most important branches. Special attention should be given to the origin of the vertebral arteries from the subclavian arteries, and to the anatomic differences in the origins of the right and left subclavian arteries; it is these features which lead to the characteristic hemodynamic consequences of stenoses or occlusions of the brachiocephalic or subclavian arteries respectively, as will be discussed in more detail later in the chapter.


Vertebral Artery Subclavian Artery Arteriovenous Malformation Left Subclavian Artery Takayasu Arteritis 


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  1. Baxter BT, Blackburn D, Payne K, Pearce WH, Yao JS (1990) Noninvasive evaluation of the upper extremity. Surg Clin North Am 70: 87–97PubMedGoogle Scholar
  2. Brunhoelzl C, von Reutern GM (1989) Hemodynamic effects of innominate artery occlusive disease. Evaluation by Doppler ultrasound. Ultrasound Med Biol 15: 201–204CrossRefGoogle Scholar
  3. Earhart RN, Aeling JA, Nuss DD, Mellette JR (1974) Pseudo-Kaposi sarcoma. Arch Dermatol 110: 907–910PubMedCrossRefGoogle Scholar
  4. Erickson SJ, Mewissen MW, Foley WD, Lawson TL, Middleton WD, Lipchik EO, Quiroz FA, Macrander SJ (1989) Color Doppler evaluation of arterial stenoses and occlusions involving the neck and thoracic inlet. Radiographics 9: 389–406PubMedGoogle Scholar
  5. Falk RL, Smith DF (1987) Thrombosis of upper extremity thoracic inlet veins: diagnosis with duplex Doppler sonography. AJR 149: 677–682PubMedGoogle Scholar
  6. Handl-Zeller L, Hübsch P, Hohenberg G, Schratter A, Wickenhauser J (1989) B-Bild und farbkodierte Dopplersonographie zur Bestrahlungsplanung bei Klippel-Trenaunay-Syndrom mit Kasabach-Merritt-Symptomatik. Ultraschall Med 10: 41–43PubMedCrossRefGoogle Scholar
  7. Hübsch P, Trattnig S, Kainberger FM, Barton P, Kamel F (1991) Darstellung peripherer arteriovenöser Malformationen mittels FarbDoppler. Ultraschall Med 12: 87–90PubMedCrossRefGoogle Scholar
  8. Lindenauer SM (1955) The Klippel-Trenaunay syndrome: Varicosity, hypertrophy and hemangioma with no arteriovenous fistula. Ann Surg 162: 303–314CrossRefGoogle Scholar
  9. Lo CM, Yeung HY, Siu KF (1987) Misdiagnosed localized arteriovenous malformation. J Vasc Surg 6: 419–421PubMedGoogle Scholar
  10. Marshall E, Hatfield ST, Hatfield DR (1985) Arteriovenous malformation simulating Kaposi’s sarcoma. Arch Dermatol 121: 99–101PubMedCrossRefGoogle Scholar
  11. McCarthy WJ, Yao JS, Schafer MF, Nuber F, Flinn WR, Blackburn D, Suker JR (1989) Upper extremity arterial injury in athletes. J Vasc Surg 9: 317–327PubMedGoogle Scholar
  12. Reading CC, Charboneau JW, Allison JW, Cooperberg PL (1990) Color and spectral Doppler mirror-image artifact of the subclavian artery. Radiology 174(1): 41–42PubMedGoogle Scholar
  13. Reed AJ, Fincher RM, Nichols FT (1989) Takayasu arteritis in a middle-aged Caucasian woman: Clinical course correlated with duplex ultrasound and angiography. Am J Med Sci 298: 324–327Google Scholar
  14. Rohrer MJ, Cardullo PA, Pappas AM, Philips DA, Wheeler HB (1990) Axillary artery compression and thrombosis in throwing athletes. J Vasc Surg 11: 761–768PubMedGoogle Scholar
  15. Schulte M (1982) Arterielle Durchblutungsstörungen. In: Gross R, Schölmerich P (Hrsg) Lehrbuch der Inneren Medizin. Schattauer, Stuttgart New YorkGoogle Scholar
  16. Trout HH, McAllister HA Jr, Giordano JM, Rich NM (1985) Vascular malformations. Surgery 97: 36–41PubMedGoogle Scholar
  17. Walker DW, Acker JD, Cole CA (1982) Subclavian steal syndrome detected with duplex pulsed Doppler sonography. Am J Neuroradiology 3: 615–618Google Scholar

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© Springer-Verlag/Wien 1992

Authors and Affiliations

  • P. Hübsch
  • S. Trattnig

There are no affiliations available

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