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Related Experiment Videos

A systematic approach to severe hand ischemia.

M F McNamara, H S Takaki, J S Yao

    Surgery
    |January 1, 1978
    PubMed
    Summary
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    Diagnosing severe hand ischemia involves various methods. Direct arterial reconstruction is effective for organic occlusions, while sympathectomy aids distal digital issues.

    Area of Science:

    • Vascular Surgery
    • Diagnostic Imaging
    • Rheumatology

    Background:

    • Severe symptomatic hand ischemia is uncommon.
    • Arterial insufficiency of the upper extremity has diverse causes.
    • Effective diagnostic and management strategies are crucial.

    Purpose of the Study:

    • To evaluate the efficacy of diagnostic manipulations for severe hand ischemia.
    • To analyze management strategies for 65 patients.
    • To correlate diagnostic findings with treatment outcomes.

    Main Methods:

    • Retrospective study design.
    • Review of patient history, Doppler ultrasound, digital arterial pressure recording, extremity angiography, serum electrophoresis, and immunoelectrophoresis.
    • Analysis of treatment outcomes including arterial reconstruction and sympathectomy.

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    Main Results:

    • History taking diagnosed traumatic, thermal, iatrogenic causes, and uremic arteritis.
    • Doppler ultrasound and digital arterial pressure confirmed ischemia severity and proximal occlusions.
    • Angiography identified chronic occlusive lesions; electrophoresis detected gammopathies.
    • Digital necrosis correlated with organic arterial occlusions.
    • Direct arterial reconstruction was effective for organic occlusions.
    • Sympathectomy served as adjuvant or definitive treatment for distal digital occlusions.

    Conclusions:

    • A multi-modal diagnostic approach is essential for severe hand ischemia.
    • Treatment strategies should be tailored to the underlying cause.
    • Direct arterial reconstruction and sympathectomy are key interventions.