1 V A S C U’iki t . 9~~b ~ w ~~’ ’~~&dquo; a ~ ~ M ~e = «’(fiR 1 G E R Y Feature Upper Extremity Vascular Problems in Athletes CORNELIUS OLCOTT, IV, M.D., RAUL J. GUZMAN, M.D., and CHRISTOPHER K. ZARINS, M.D. C.O., IV, Professor of Surgery; Chief, Division of Vascular Surgery, Stanford University School of Medicine, Stan- ford, CA; R.J.G.; C.K.Z., Vascular Surgeons, Division of Vascular Surgery, Vanderbilt University School of Medicine, Nashville, TN. ABSTRACT Upper extremity vascular injuries are being seen with increasing frequency. These injuries particularly involve the subclavian artery and vein, the axillary artery, and the arteries of the hand. Stretch injury to the branches of the axillary artery may also occur, leading to aneurysm formation. These aneurysms may develop intraluminal thrombus, which can embolize as a result of compression of the aneurysm with repetitive activity. Noninvasive testing has been found to be very helpful in the diagnosis of these sports-related injuries. Proper management depends upon the vessel involved. With appropriate man- agement, results have been good, and the majority of these athletes, profes- sional and amateur, return to full athletic activity. Keywords Upper extremity, ischemia, aneurysm Perspectives in Vascular Surgery Vol. 10( 1 ), pp. 1-18, 1999. Sports, both amateur and professional, have become an expanding part of American culture. As a result, physicians are seeing an increasing number of sports related injuries. Although most athletic injuries involve the musculo- skeletal system and hence are the province of the orthopedic surgeon or sports medicine specialist, injuries to the vascular system are being seen with increasing frequency. Vascular related athletic injuries involve primarily three areas: the shoulder girdle (axillary and subclavian vessels), the hip (iliac ves- sels), and the knee (popliteal vessels). These injuries may involve either the