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 < .01). We observed an improvement of pain, ulcers and infection healing in all treated remaining patients during the postoperative period.Conclusion: Percutaneous intervention prevents hand loss and functional impairment in patients with Critical Hand Ischemia and multiple comorbidities. (C) 2020 Elsevier Inc. All rights reserved.
Morosetti, D., D'Onofrio, A., Argiro, R., Di Martino, A., Vidali, S., Nezzo, M., et al. (2020). Endovascular Treatment of Critical Hand Ischemia: A Single-Center Experience. CARDIOVASCULAR REVASCULARIZATION MEDICINE, 21(11), 1438-1443 [10.1016/j.carrev.2020.04.017].
|Tipologia:||Articolo su rivista|
|Citazione:||Morosetti, D., D'Onofrio, A., Argiro, R., Di Martino, A., Vidali, S., Nezzo, M., et al. (2020). Endovascular Treatment of Critical Hand Ischemia: A Single-Center Experience. CARDIOVASCULAR REVASCULARIZATION MEDICINE, 21(11), 1438-1443 [10.1016/j.carrev.2020.04.017].|
|Settore Scientifico Disciplinare:||Settore MED/36|
|Revisione (peer review):||Esperti anonimi|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1016/j.carrev.2020.04.017|
|Stato di pubblicazione:||Pubblicato|
|Data di pubblicazione:||nov-2020|
|Titolo:||Endovascular Treatment of Critical Hand Ischemia: A Single-Center Experience|
|Autori:||Morosetti, D; D'Onofrio, A; Argiro, R; Di Martino, A; Vidali, S; Nezzo, M; Wlderk, A; Ros, V; Gandini, R|
|Appare nelle tipologie:||01 - Articolo su rivista|