PMC10155728_01
PMC10155728_02
Finger tips of right hand with faint blue discoloration (red arrow).
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On her right upper extremity exam, the patient had a faint bluish discoloration on her fingers, nonpalpable brachial and radial pulses, 4/5 upper extremity strength, and decreased sensation compared to a normal left upper extremity exam (Figure 1).
Point of care ultrasound with color Doppler mode in a transverse view utilizing a linear probe to visualize echogenic embolic material (yellow arrow) in the right proximal brachial artery, which was noncompressible and without any Doppler flow signal.
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POCUS with Doppler was immediately employed and visualized an occlusion at the proximal brachial artery (Figures 2 and 3).
Point of care ultrasound in a longitudinal view utilizing a linear probe to visualize embolic material occluding the lumen of the proximal right brachial artery (yellow arrow).
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POCUS with Doppler was immediately employed and visualized an occlusion at the proximal brachial artery (Figures 2 and 3).
CT angiography of the right upper extremity in the coronal plane. There is a filling defect seen in the proximal right brachial artery at the level of the right humeral neck characteristic of 3 cm embolus (yellow arrow). There is a small amount of flow around this embolus into the mid right brachial artery.
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Vascular surgery was immediately consulted and a CT angiography (CTA) of the right upper extremity was expedited, showing a 3 cm embolus in the proximal right brachial artery (Figures 4 and 5).
CT angiography of the right upper extremity in the axial plane. There is a filling defect seen in the proximal right brachial artery at the level of the right humeral neck characteristic of embolic debris (yellow arrow).
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Vascular surgery was immediately consulted and a CT angiography (CTA) of the right upper extremity was expedited, showing a 3 cm embolus in the proximal right brachial artery (Figures 4 and 5).