Ulnar artery thrombosis and the role of interposition vein grafting: patency with microsurgical technique

Eight consecutive cases of chronic ulnar artery thrombosis at the wrist managed with microsurgical interposition vein grafting were evaluated for long-term patency and clinical results. At a minimum of one-year follow-up, seven of eight vein grafts (88%) were patent by Doppler and Allen's tests. For the patent grafts, functional results were excellent in four (57%) and improved in three. For the nonpatent graft, the function was not improved. Patent vein grafts restored the pulse volume recording amplitudes in painful digits to normal in six of seven cases, although slow rewarming after ice immersion suggested residual vasospastic disease in two. The most favorable outcomes were in (1) nonsmokers, with (2) a single, distinctly recalled history of trauma to the palm, and (3) preoperative symptoms of less than 5 months' duration before treatment. Interposition vein grafts can be used to restore pulsatile digital blood flow to painful digits after thrombosis of the ulnar artery.