| Acute and chronic ischemia of the hand: pathophysiology, treatment, and prognosis. | |
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MedLine Citation:
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PMID: 1748754 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Fifty consecutive patients with acute and chronic ischemia of the hand were investigated by Allen testing, Doppler ultrasound, digital plethysmography, and angiography over a 4-year period. The pathophysiologic mechanism responsible for the ischemia was determined to be emboli in 6%, vasospasm in 10%, thrombosis or "sludging" in 28%, occlusive disease in 26%, and occlusive disease associated with either vasospasm or external compression in 30%. Ten patients required emergency medical treatment with intraarterial streptokinase, intravenous heparin, or dextran 40 and continuous stellate ganglion blocks, and three patients required emergency microsurgical revascularization because of radial artery thrombosis. Patients with chronic ischemia of the hand were maintained on nifedipine, 30 to 60 mg daily, and pentoxifylline, 1200 mg daily. Seven patients underwent digital sympathectomy and 14 patients underwent microsurgical revascularization as prophylactic procedures for chronic digital ischemia. Amputations were required in 18 patients because of end-stage gangrene. Long-term follow-up revealed a 20% incidence of recurrent digital ulcerations. There have been six deaths during follow-up, five of them due to myocardial infarction; this reflects the underlying systemic arteriopathy in many of these patients. |
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Authors:
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N F Jones |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Journal of hand surgery Volume: 16 ISSN: 0363-5023 ISO Abbreviation: J Hand Surg Am Publication Date: 1991 Nov |
Date Detail:
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Created Date: 1992-01-23 Completed Date: 1992-01-23 Revised Date: 2009-06-08 |
Medline Journal Info:
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Nlm Unique ID: 7609631 Medline TA: J Hand Surg Am Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1074-83 Citation Subset: IM |
Affiliation:
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Division of Plastic and Reconstructive Surgery, University of Pittsburgh, PA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Adolescent Adult Aged Child Chronic Disease Female Follow-Up Studies Hand / blood supply* Humans Ischemia* / diagnosis, etiology, physiopathology, surgery Male Middle Aged Prognosis |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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