Endovascular Treatment of Critical Hand Ischemia: A Single-Center Experience
| Autor: | Renato Argirò, Valerio Da Ros, Sofia Vidali, Roberto Gandini, Marco Nezzo, Adolfo D'Onofrio, Daniele Morosetti, Arezia Di Martino, Andrea Wlderk |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Arteriovenous fistula Arterial Occlusive Diseases 030204 cardiovascular system & hematology Revascularization 03 medical and health sciences Ulnar Artery 0302 clinical medicine Settore MED/36 Ischemia medicine.artery Angioplasty Occlusion medicine Humans 030212 general & internal medicine Radial artery Ulnar artery Retrospective Studies Peripheral Vascular Diseases medicine.diagnostic_test Endovascular business.industry Endovascular Procedures General Medicine medicine.disease Hand Surgery Stenosis Treatment Outcome Angiography Cardiology and Cardiovascular Medicine business |
| Popis: | Purpose To clarify the role of endovascular treatment in patients with Critical Hand Ischemia of the distal upper extremity. Methods From January 2012 to January 2017, 18 dialyzed patients presented chronic critical hand ischemia; 6 patients had a chronic occlusion of the ulnar artery and radial artery stenosis, 5 patients had a chronic occlusion of the radial artery and ulnar artery stenosis, 4 patients presented multiple stenosis of the ulnar, radial and interosseous arteries, 2 patients had only ulnar artery occlusion while one patient presented only radial artery occlusion. All patients underwent duplex ultrasound and a subsequent brachial angiography, in order to evaluate the distal run-off circulation. Revascularization was achieved via antegrade brachial puncture in all patients, with retrograde approach in 4 patients, with distal retrograde puncture in 3 patients and in one patient with loop technique. Results No complications were observed during the periprocedural follow-up. One patient was not successfully revascularized (technical success rate: 94.4%). The patient had no direct flow after ulnar artery angioplasty. The procedure was clinical effective in 15 patients (clinical success rate: 83.3%). Clinical evaluation and Duplex-US were performed in the follow up period. TcpO2 evaluated in the perilesional skin surface increased from 20.2 ± 6.5 mmHg to 53.8 ± 13.1 mmHg in the follow up period (P Conclusion Percutaneous intervention prevents hand loss and functional impairment in patients with Critical Hand Ischemia and multiple comorbidities. |
| Databáze: | OpenAIRE |
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