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Related Experiment Videos

[Acute digital ischemia: a microsurgical emergency].

P Mortier1, M Schoofs, P Leps

  • 1Service de chirurgie plastique et reconstructrice, centre des brûlés, hôpital Roger Salengro, CHRU, 59037 Lille, France.

Annales De Chirurgie Plastique Et Esthetique
|May 9, 2001
PubMed
Summary

This study presents an aggressive microsurgical approach for acute finger ischemia, successfully preventing amputations in 14 patients. Early intervention with thrombectomy and anticoagulation proved effective for embolic causes.

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Area of Science:

  • Vascular Surgery
  • Emergency Medicine
  • Microsurgery

Context:

  • Acute finger ischemia presents a surgical challenge, often requiring prompt intervention to preserve limb viability.
  • Embolic events, particularly from ulnar aneurysms and atrial fibrillation, are significant causes of acute digital ischemia.
  • Traditional management may involve amputation, highlighting the need for effective revascularization techniques.

Purpose:

  • To report the experience and outcomes of an aggressive microsurgical treatment strategy for acute finger ischemia.
  • To evaluate the efficacy of thrombectomy and anticoagulation in managing embolic digital artery occlusion.
  • To assess the long-term limb salvage rates following this intervention.

Summary:

  • Fourteen patients with acute finger ischemia underwent microsurgical intervention, including thrombectomy and Fogarty's probe extraction of emboli.

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  • The underlying causes were primarily ulnar aneurysms (9 cases) and atrial fibrillation (5 cases).
  • Aggressive treatment involving microsurgical dissection, thrombectomy, and early postoperative anticoagulation resulted in no secondary amputations over a five-year follow-up.

    • Impact:

    • This microsurgical approach offers a viable limb-salvage option for acute finger ischemia caused by emboli.
    • The study demonstrates the effectiveness of early and aggressive intervention in preventing amputation.
    • This technique is specifically indicated for acute embolic ischemia, not for chronic or inflammatory arteriopathies.