Sage Journals: Discover world-class research

Abstract

Objectives

This study aims to report the technical results of below-the-elbow arterial revascularization in patients with critical hand ischemia.

Methods

We retrospectively identified upper extremity critical limb ischemia patients treated with below-the-elbow arterial intervention between 2013 and 2017. Patient demographics, comorbidities, and procedural data were reviewed and technical success was evaluated.

Results

Seven patients with 12 arteries that were affected by critical hand ischemia were treated. All patients had a history of end-stage renal disease. The technical success rate was 83.3%. There were no major or minor complications. The average follow-up duration was 9 months (2–26 months). One patient underwent a digital amputation at 8 months.

Conclusion

Arterial revascularization of the below-the-elbow arteries for critical hand ischemia is safe and technically feasible.

Keywords

Vascular upper extremity critical limb ischemia angioplasty hand

Get full access to this article

View all access options for this article.

References

Ferraresi

Palloshi

Aprigliano

, et al. Angioplasty of below-the-elbow arteries in critical hand ischaemia. Eur J Vasc Endovas Surg 2012; 43: 73–80.

Okamoto

Iida

Mano

. Current perspective on hemodialysis patients with peripheral artery disease. Ann Vasc Dis 2017; 10: 88–91.

Kawarada

Yokoi

Higashimori

. Angioplasty of ulnar or radial arteries to treat critical hand ischemia: use of 3- and 4-French systems. Catheterization Cardiovas Interv 2010; 76: 345–350.

Leon

Asif

. Arteriovenous access and hand pain: the distal hypoperfusion ischemic syndrome. Clin J Am Soc Nephrol 2007; 2: 175–183.

Wetmore

Collins

. Global challenges posed by the growth of end-stage renal disease. Ren Replace Ther 2016; 2: 15.

Gandini

Fabiano

Morosetti

, et al. Endovascular treatment of below-the-elbow arteries in critical hand ischemia. Minerva Cardioangiologica 2016; 64: 662–671.

Woo

Fairman

Velazquez

, et al. Endovascular therapy of symptomatic innominate-subclavian arterial occlusive lesions. Vasc Endovas Surg 2006; 40: 27–33.

Roddy

Darling

III Chang

, et al. Brachial artery reconstruction for occlusive disease: a 12-year experience. J Vas Surg 2001; 33: 802–805.

Deguara

Ali

Modarai

, et al. Upper limb ischemia: 20 years experience from a single center. Vascular 2005; 13: 84–91.

10.

Mills

Friedman

Taylor

Jr , et al. Upper extremity ischemia caused by small artery disease. Ann Surg 1987; 206: 521–528.

11.

Gandini

Angelopoulos

Ros

, et al. Percutaneous transluminal angioplasty for treatment of critical hand ischemia with a novel endovascular approach: “the radial to ulnar artery loop technique”. J Vasc Surg 2010; 51: 760–762.

12.

Ruzsa

Berta

Tóth

, et al. Short- and long-term results with a percutaneous treatment in critical hand ischaemia. Catheter Cardiovas Interv 2019; 93: 1301–1310.

13.

Ozen

Zhu

, et al. Outcomes of subintimal arterial flossing with antegrade-retrograde intervention on patients with critical limb ischemia and tissue loss. Vasc Med 2021; 26(2): 207–209. DOI: 10.1177/1358863X20964573. PMID: 33111637. Epub 2020 Oct 28.

Technical outcomes of below-the-elbow revascularization for upper extremity critical limb ischemia