Thoracic Outlet Syndrome-An Uncommon Cause of Acute Upper-Limb Ischemia.

ABSTRACT: Acute upper-limb ischemia is usually secondary to thromboembolic occlusion. The heart is the usual source of emboli in the majority of patients. In a small percentage of cases, the thromboembolic process may start in a proximal large-sized artery, such as the subclavian artery, resulting in thromboembolic occlusion of the upper extremity's small peripheral arteries. In patients with acute upper-limb ischemia, a systematic color flow Doppler ultrasound of the upper extremity arteries may reveal thoracic outlet syndrome as the underlying cause. This pictorial review presents a systemic color flow Doppler approach to evaluate upper extremity arteries in patients with thoracic outlet syndrome presenting as acute ischemia.