J Cardiovasc Surg
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The occlusive arterial lesions of the upper extremity in Takayasu's arteritis is estimated in 72.3% in the left and in 45.6% in the right subclavian arteries, respectively. Buerger's disease also involves the arteries distal to the elbow and the digital arteries in about 22% of total cases. In Takayasu's arteritis, the surgical treatment for the upper extremity ischemia is rarely indicated, except for the cases with aneurysm, because the occlusive lesion involves exclusively the aorta and its branches, and severe ischemia of the upper digital arteries in Buerger's disease frequently causes severe ischemic symptoms of hand and fingers, such as rest pain, trophic changes and tissue loss. Therefore, the surgical treatment, including upper thoracic sympathectomy and amputation, is mandatory in some cases.