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Complications Following Vascular Procedures in the Upper Extremities: A Sonographic Pictorial Review

Millet, John D. BA*; Gunabushanam, Gowthaman MD*†; Ojili, Vijayanadh MD; Rubens, Deborah J. MD§; Scoutt, Leslie M. MD*

doi: 10.1097/RUQ.0b013e31827c6ad8
Pictorial Essay

The arteries of the upper extremities are increasingly utilized to gain access for angiography, percutaneous coronary interventions, endovascular therapy, and continuous hemodynamic monitoring. Hence, complications after upper-extremity arterial interventions are increasing in incidence. Similarly, the incidence of upper-extremity deep venous thrombosis is increasing as venous access is increasingly achieved with upper-extremity central line placement. Knowledge of the sonographic appearance of these complications is essential as ultrasound is often the only imaging modality used in the evaluation of suspected vascular injury. This pictorial review demonstrates the spectrum of complications observed following vascular procedures in the upper extremities, including thrombosis, hematoma, pseudoaneurysm, arteriovenous fistula, and arterial dissection. Gray-scale, color, and pulsed Doppler imaging findings are described, and pertinent management issues, including endovascular and surgical therapies, are briefly discussed.

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*Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT;†Department of Radiology, VA Medical Center, West Haven, CT; ‡Department of Radiology, University of Texas Health Science Center, San Antonio, TX; and §Department of Imaging Sciences, University of Rochester Medical Center, Rochester, NY.

Received for publication July 1, 2012; accepted October 18, 2012.

The authors declare no conflict of interest.

Reprints: John D. Millet, BA, Yale Diagnostic Radiology, PO Box 208042, New Haven, CT 06520 (e-mail:

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© 2013 Lippincott Williams & Wilkins, Inc.