Presentation
Right upper extremity pain and paresthesiae.
Patient Data
There is an eccentric, non-occlusive filling defect within the right brachycephalic artery, which occupies approximately 80% of the cross-sectional luminal area. Remainder of the visualized thoracic arterial system is free of any other luminal filling defects.
There is abrupt occlusion/nonopacification of the proximal deep palmar arch arteries adjacent to their origins from the ulnar and radial arteries. The superficial palmar arch appears intact, and there is opacification of the common and proper digital arteries.
Case Discussion
This is a case of a thrombus within the brachiocephalic (innominate) artery which likely seeded emboli within the right upper extremity and caused ischemia. The patient subsequently developed gangrene on the fourth digit distal to the proximal interphalangeal joint.
Co-author:
Camille Dumas, DO
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