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 balloon catheter embolectomy is performed. If there is no arterial pulse detectable, 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 embolectomy and subsequent cerebral embolization. For direct surgical embolectomy the authors recommend a supraclavicular incision.