Long-term successful outcome of severe hand ischemia using arterialization with reversal of venous flow: case report

The management of unreconstructible vascular lesions in the hand is a challenge with limited options for treatment. After 22 years of hand ischemia, involving management with reverse interpositional vein grafting, periarterial sympathectomy, and partial finger amputations, a 62-year-old man underwent arterialization of the venous system of the hand for unreconstructible distal vascular lesions as a salvage procedure. At 7-year follow-up, the patient is pain-free with good functional and health-related quality of life outcomes and no further amputations. This procedure may be considered as a salvage alternative to prevent additional amputation in selected patients.