Digital ischemia: Etiologies and long-term follow up. A cohort study of 323 patients

BioRxiv : the Preprint Server for Biology
Alizée RAIMBEAUO Espitia

Abstract

Abstract Aim: Upper Extremity Digital ischemia (UEDI) is a rare heterogeneous condition with digital upper limb ischemia occurring forty times less frequently than toe ischemia. Using the largest cohort ever published, the aim of this study was to evaluate etiologies, treatments, prognosis and long-term clinical outcomes of DI. Method: Patients included had UEDI with or without cutaneous necrosis. They were followed in a university hospital setting between January 2000 to December 2016. Etiologies, recurrence of UEDI, digital amputation and overall survival were analyzed retrospectively. Results: DI due to cardio-embolic disease (DICE) was the highest occurring etiology with 59 patients (18.3%), followed by UEDI due to Systemic Sclerosis (SSc) (16.1%), idiopathic causes (11.7%), Thromoboangitis obliterans (TAO) (9.3%), iatrogenic causes (9.3%) and cancer (6.2%). DICE patients tended to fall into an older age bracket and featured a greater numbers of cases with hypertension whereas TAO patients smoked more tobacco and cannabis. DICE presented a greater number of cases with paleness and neuropathic and nociceptive pain whereas SSc patients presented more cases with necrotic pathophysiology. Long-term follow-up of this study showe...Continue Reading

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