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Upper extremity ischemia caused by small artery disease
J L Mills1, E I Friedman, L M Taylor
1Division of Vascular Surgery, Oregon Health Sciences University, Portland 97201.
Annals of Surgery
|October 1, 1987
Summary
Ischemic finger ulceration is often linked to serious underlying diseases. Conservative treatments show high healing rates, but autoimmune conditions like scleroderma may increase recurrence risk.
Area of Science:
- Vascular Surgery
- Rheumatology
- Dermatology
Background:
- Ischemic finger ulceration is a challenging clinical condition.
- Identifying associated systemic diseases is crucial for effective management.
- Understanding the natural history and treatment response is essential.
Purpose of the Study:
- To determine the incidence of associated diseases in patients with ischemic finger ulceration.
- To evaluate the response to conservative treatment.
- To describe the natural history of the condition.
Main Methods:
- Prospective evaluation of 100 patients with ischemic finger ulceration.
- Detailed assessment for associated systemic diseases.
- Monitoring of treatment response and long-term outcomes.
Main Results:
- A serious associated disease was detected in all 100 patients.
- Autoimmune disease (54%), hypersensitivity angiitis (22%), Buerger's disease (9%), and arteriosclerosis obliterans (9%) were common.
- Conservative treatment achieved long-term healing in 88% of patients.
- Recurrences were more frequent in patients with autoimmune diseases, particularly scleroderma or CRST.
Conclusions:
- Ischemic finger ulceration is consistently associated with significant systemic diseases.
- Conservative management is effective for most patients.
- Autoimmune conditions necessitate careful monitoring due to higher recurrence rates.