PMC9616673_01
PMC9616673_02
A photograph that shows swelling, cyanosis, and skin maceration in the left forearm and hand of our patient.
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fig1
Physical examination there revealed below elbow cyanosis and skin maceration in the left upper limb (Figure 1).
CTA shows a contrast filling defect in the left subclavian artery, starting about 2 cm from the origin of the aortic arch as a result of left subclavian artery thrombosis.
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fig2
There was a contrast filling the proximal 1 cm of the axillary artery mostly from collaterals with a complete cutoff of the contrast thereafter until the level of the midarm, after which arterial contrast filling resumed until the level of the elbow with no contrast flow beyond the level of the elbow joint, consistent with a diagnosis of left subclavian artery thrombosis that is causing upper limb ischemia (Figure 2).
A photograph that shows left forearm and hand gangrene in our patient after the failure of medical management.
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fig3
Her limb showed no improvement and developed wet gangrene (Figure 3).