Recurrent upper extremity acute limb ischemia secondary to retained axillary polytetrafluoroethylene cuff causing axillary stump syndrome

Abstract

Acute limb ischemia of the upper extremity is less frequently encountered than in the lower extremity. The etiology is typically cardioembolic. Axillary-femoral stump syndrome is a rare complication associated with an occluded axillary-femoral bypass graft. We present the case of recurrent acute limb ischemia of the upper extremity whose embolic source was a retained cuff of a previously explanted axillary-profunda bypass graft. The patient failed anticoagulation after an initial embolectomy and after a recurrent embolism from the retained cuff, ultimately required cuff exclusion with a covered stent.

Contralateral brachial arterial access for endovascular treatment of recurrent axillofemoral bypass graft stump syndrome: A case report

“…In axillofemoral bypass graft stump syndrome, a thrombosed graft can cause embolism; therefore, surgical removal of the bypass is necessary [2] . In previous reports, most patients with axillofemoral bypass graft syndrome underwent surgery.…”

“…Acute limb ischemia of the upper extremity is an uncommon disease, and the cause is mostly cardioembolic [1] . Axillofemoral bypass graft stump syndrome is a rare condition in which the upper extremity is obstructed by thromboembolism from an occluded axillofemoral bypass graft [ 2 , 3 ]. Reportedly, most cases were treated with surgical correction, and endovascular treatment was rarely performed [3] .…”

Acute Upper Extremity Ischemia Due to Cardioembolism From Undiagnosed Atrial Fibrillation

“…Rare presentations of upper extremity ischemia include dialysis access steal syndrome and ischemic monomelic neuropathy. However, axillary-femoral stump syndrome is another rare etiology of upper extremity ischemia [ 6 ].…”