Arteriography and interventional therapy for diseases of the hand

Because the vessels of the hand are small and very responsive to stimuli, arteriography of the hand requires painstaking technique, temperature control, and sometimes vasodilator administration to produce sufficient radiographic detail. Twenty-five patients underwent arteriography of the hand, which was performed from a transfemoral approach to evaluate pathologic changes and the possibility of interventional treatment. Production of high-quality images by means of attention to technical factors particular to the hand permitted recognition of radiographic detail essential to diagnosis. Twelve patients had a history of trauma, and five patients had congenital lesions. In eight patients, atherosclerotic, vasospastic, or embolic arterio-occlusive disease was diagnosed. Interventional radiologic procedures such as thrombolysis, therapeutic embolization, and percutaneous transluminal angioplasty are important adjuvant or primary management options. Angiography of vascular hand lesions can yield high-quality diagnostic images when technical factors and physiologic variables are maximized. Differentiation between traumatic, congenital, and occlusive lesions is then possible.