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

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.