Digital ischemic necrosis in a patient with systemic sclerosis: the role of laser Doppler perfusion imaging
| Autor: | Simonetta Pisarri, Felice Salsano, Edoardo Rosato, E. Roumpedaki |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
medicine.medical_specialty
systemic sclerosis medicine.medical_treatment Ischemia adventitiectomy digital ischemia laser doppler perfusion imaging raynaud's phenomenon Perfusion scanning Arterial Occlusive Diseases Pallor Microcirculation Fingers Necrosis Skin Ulcer Laser-Doppler Flowmetry Medicine Humans Skin Ultrasonography Gangrene Wound Healing business.industry Blood flow Laser Doppler velocimetry Middle Aged medicine.disease Surgery Treatment Outcome Amputation Ischemic Attack Transient Regional Blood Flow Scleroderma Diffuse Female Radiology medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | VASA. Zeitschrift fur Gefasskrankheiten. 38(4) |
| ISSN: | 0301-1526 |
| Popis: | The impairment of microcirculation is a cardinal feature of systemic sclerosis (SSc). Raynaud’s phenomenon and SSc can cause painful digital ulcers on the fingers or toes, with resulting complications such as serious infections, gangrene or possible amputation. This case report shows the possible role laser Doppler perfusion imaging (LDPI) could play in diagnosis and follow-up of digital arterial obstructions in SSc patients. LDPI is a non-invasive microvascular imaging technique able to provide maps of the cutaneous blood flow (CBF). We describe here the case of a woman affected by SSc who suddenly presented with pallor and pain; afterwards an area of necrosis became clearly visible at the distal phalanx of the third right finger. The LDPI of the dorsal surface of that finger showed a reduction of CBF. Selective arteriography was performed in order to assess the degree and location of the obstruction before proceeding with adventitiectomy. Following this procedure LDPI showed a normal CBF in the distal phalanx and complete healing of the necrotic area. Consequently, we can state that LDPI alone provides an indirect functional estimation of possible digital artery obstruction. Further, we can assert that the overall effect of the adventitiectomy resulted in an increase of the CBF. |
| Databáze: | OpenAIRE |
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