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Rarely, frostbite, radiation therapy for breast cancer, and repeated injury, for example, to the pad of your hand, or other forms of injury, can cause arm artery disease.
Arm artery disease is more likely to affect you if you smoke and are older than age 60. Other risk factors include having high cholesterol or high blood pressure.
First your physician asks you questions about your general health, medical history, and symptoms. In addition, your physician conducts a physical exam. Together these are known as a patient history and exam. As part of your history, your physician will ask you if you smoke or have high blood pressure. Your physician will also want to know when and how often your symptoms occur as well as their location.
As part of your exam, your physician will take your blood pressure in both arms. If your blood pressure is significantly lower in one arm, that arm most likely has a blockage. Your physician will feel for a pulse below the suspected blockage. If you have arm artery disease, this pulse will be weak or even missing. Your physician will also listen to your arm arteries with a stethoscope. Abnormal whooshing sounds, called bruits, may suggest blood is flowing through a narrowed artery.
After your exam, if your physician suspects arm artery disease, he or she may perform tests, such as:
Your treatment for arm artery disease will depend on the underlying cause, as well as the location and severity of any blockages. If you have high blood pressure, your physician may prescribe medications that treat those conditions. Some prescription medications may help Raynaud's disease. If you have Buerger’s disease, quitting smoking is the most important treatment.
Some physicians use an anesthetic injection, called a sympathetic block, to block certain nerves in the hands. If this procedure relieves your symptoms, your physician may recommend cervical sympathectomy. Cervical sympathectomy can be done surgically or sometimes by chemical injection. This procedure interrupts the nerves that cause your arteries to spasm.
If a large blood vessel in your arm is blocked, your physician may be able to treat it with an angioplasty procedure, depending upon the location and how much of the blood vessel is blocked. During an angioplasty procedure, which is sometimes performed at the same time as an angiogram, a long, thin, flexible tube, called a catheter, is inserted into a small puncture and is guided through your arteries to the blocked area. Once there, a special balloon attached to the catheter is inflated and deflated, several times if needed. The balloon pushes the plaque in your artery against your artery walls, widening the vessel. In some circumstances, a tiny mesh-metal tube called a stent may then be placed into the narrowed area of your artery to keep it open. The stent remains permanently in your artery. After successful angioplasty, blood flows more freely through your artery.
For more extensive blockages, you may need a surgical repair such as endarterectomy or bypass. An endarterectomy is a way for your surgeon to remove the plaque from your artery. To perform an endarterectomy, your vascular surgeon makes an incision and removes the plaque contained in the inner lining of the diseased artery. This leaves a wide-open artery and restores blood flow through it. To perform a bypass, your vascular surgeon creates a detour around your blocked artery with a synthetic tube or a vein from your body.
If the arm blood vessel blockage is associated with Thoracic Outlet Syndrome (see the associated article on Thoracic Outlet Syndrome), a surgical procedure to remove an extra rib or to relieve pressure on the vessel may also be required.
The best choice of the treatment depends upon several considerations including your general health, the pattern and particular cause of the obstruction, and how much blockage that you have. Your vascular surgeon will help you determine which method of treatment is best for your particular situation.
Although many treatments are available for arm artery disease, there is no cure. Lifestyle changes that help you manage risk factors for arm artery disease include:
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