Upper extremity arterial occlusions can have a variety of presenting factors. Two of the most commonly described features are coldness and pain in the affected extremity, often occurring distally first and moving proximally. The pain is often a rest pain in acute occlusion but could also be claudication. Other presenting findings include paresthesia, paralysis, cyanosis, or pallor, decreased or absent radial or ulnar pulse, and gangrene of the digits . If any of these symptoms are present, it is important to consider an arterial occlusion of the upper extremity. The patient will often also have predisposing conditions to thrombus formation and subsequent embolization. These conditions include myocardial infarction, atrial fibrillation, valvular heart disease, and other less common cardiac and noncardiac causes of emboli .