Direct revascularization for the treatment of forearm and hand ischemia

American Journal of Surgery
S G Katz, R D Kohl

Abstract

During an 8-year period, 65 patients underwent operation for ischemia of the arm and hand. Fifty-four patients presented with an acutely ischemic extremity. Twenty-two had cardiac origin emboli, 9 had arterial-arterial emboli, 8 had traumatic occlusion of the brachial artery, and 15 patients developed arterial insufficiency after iatrogenic intervention. Twenty-one of 22 patients with cardiac emboli were successfully treated with embolectomy alone. The majority of patients with arterial-arterial emboli and traumatic or iatrogenic injuries required arterial reconstruction in addition to clot retrieval. After operation, 53 of 54 patients were asymptomatic. Eleven patients underwent operation for chronic ischemia. Seven patients had axillo-brachial saphenous vein grafts, two had carotid-subclavian bypass grafts, and two patients underwent aorto-innominate bypass. All grafts remained patent during follow-up that ranged from 6 months to 8 years. We conclude that operative therapy is very effective in preventing limb loss and functional impairment in patients with acute or chronic upper extremity ischemia.

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Citations

Oct 22, 1998·The British Journal of Surgery·P Eyers, J J Earnshaw
Dec 3, 2014·Hand Clinics·Helen G Hui-Chou, Michael A McClinton
Sep 24, 2013·The American Journal of Emergency Medicine·Selcuk CoskunMurat Bayazıt
Aug 21, 2012·Journal of Vascular Nursing : Official Publication of the Society for Peripheral Vascular Nursing·E Jane H TurnerAdam Howard
Aug 12, 2008·Annals of Vascular Surgery·Ingolf TöpelPiotr M Kasprzak
Jul 9, 2011·Journal of Thrombosis and Haemostasis : JTH·L V AndersenL Frost
Jul 14, 2010·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·L V AndersenL Frost
Mar 1, 1997·Journal of Vascular Surgery·K A BrusettM A Marjani
Jan 20, 2011·Annals of Saudi Medicine·Shi-Min Yuan, Hua Jing
Jan 16, 2007·The American Journal of Sports Medicine·Keith M BaumgartenAnsworth Allen
Oct 10, 2007·The Journal of Hand Surgery·Surena NamdariWilfred I Carney
May 1, 2018·Case Reports in Plastic Surgery & Hand Surgery·Lohrasb R SayadiJames G Thomson
Aug 27, 2005·Orthopedics·Hakan GundesAyhan Arpaci
Aug 6, 1999·Journal of Vascular and Interventional Radiology : JVIR·S P JohnsonD A Kumpe

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