Diagnostic and surgical approach of innominate artery saddle embolus

Patients with an acute arterial occlusion of the right upper extremity and absent axillary pulse should have a Doppler scan examination before a ballo on catheter embolectomy is performed. If there is no arterial pulse detecta ble, an angiography should be performed afterwards to localize the embolus. In the case of a proximal arterial occlusion of the right arm, the authors recommend this procedure to prevent an embolus dislocation by catheter emb olectomy and subsequent cerebral embolization. For direct surgical embolect omy the authors recommend a supraclavicular incision. (C) 1999 The Internat ional Society for Cardiovascular Surgery. Published by Elsevier Science Ltd . All rights reserved.