Prepared by Dr . The patient has a 30 pack yr of smoking tobacco.
Physical exam reveals palpable bilateral radial pulses, brachial pulses, and axillary pulses.
Ulnar pulses are not palpable on either hand. Duplex ultrasound demonstrates occlusion of ulnar arteries bilaterally and diminsihed digital arterial pressures. An Angiogram was performed. Aortic arch and upper extremity arteriograms show normal subclavian, axillary, brachial, radial arteries. Both ulnar arteries are occluded proximal to the wrist.