About the disease

Upper extremities atherosclerosis is a disease, characterized by hardening of arm arteries. This can lead to obstructions in the blood circulation, which poses a danger to overall mobility of arms. The main danger of atherosclerosis is the heart attack, which can develop due to continuous problems with proper blood circulation. Atherosclerosis of upper extremities develops gradually and can be latent for several years before manifesting itself. The main symptom is continuous dull pain in the arms and inability to fully move and use arms.

 Most commonly, upper extremities atherosclerosis develops as a result of stenosis of subclavian arteries, located below the clavicle. These arteries are responsible for supplying right and left arms with blood. When these arteries become narrowed, they also harden, thus developing atherosclerosis and supplying insufficient amount of blood to the arms.      

Atherosclerosis can develop as a result of long-term smoking, obesity and extremely high cholesterol levels in the blood, which cause arteries to harden. Certain autoimmune diseases such as insulin can also cause development of upper extremities atherosclerosis. There`s also high risk of developing atherosclerosis in lower extremities in people who didn't get timely diagnosis and treatment.

Symptoms

• Pain in the arms
• Stiffness
• Reduced mobility of the arms
• Blue fingers
• Cold skin
• Weak blood pressure in arms
• Numbness of fingers

Diagnosis

During a general examination a doctor will check the pulse in the arms. It is usually very weak in people with upper extremities atherosclerosis. A doctor will also determine if a patient has decreased blood pressure in the arms. 

A duplex ultrasound is used to examine the blood flow in the arteries. The subclavian arteries and majorly examined as they are mostly responsible for supplying arms with blood.

Angiogram is also very often used to acquire the image of arteries and determine if any of them are hardened or have extremely high cholesterol levels. 

Treatment

Angioplasty, stenting is a surgical procedure used to widen the hardened and narrowed arteries with a special inflated balloon. After the artery is inflated, a special stent is placed inside to keep it open and prevent it from closing again in future. As there are two subclavian arteries, which can be narrowed or hardened, a stent can be placed in these two arteries and normalize the blood flow to both arms. This is a highly efficient surgery used for treatment of all hardened arteries. 

Thrombectomy is a surgery, used to remove the clots in the artery, which could have accumulated in case of atherosclerosis. It is very important to remove such blood clots as they pose danger to overall blood circulation and can result in heart failure. The procedure is simple and a patient recovers quickly.

Authors: Dr. Nadezhda Ivanisova, Dr. Sergey Pashchenko