Document Detail


Angioplasty of ulnar or radial arteries to treat critical hand ischemia: use of 3- and 4-French systems.
MedLine Citation:
PMID:  20839345     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The aim of this preliminary study is to report the results of catheter-based treatment for isolated distal upper extremity artery disease with CHI.
BACKGROUND: Critical hand ischemia (CHI) is a rare but potentially devastating condition.
METHODS: The study consisted of five critically ischemic hands (Rutherford category 4: 2, Rutherford category 5: 3) in four patients undergoing catheter intervention for isolated distal upper extremity artery disease between November 2007 and April 2009.
RESULTS: Balloon angioplasty via an antegrade brachial approach was performed with a 3Fr or 4Fr sheath to achieve the principal endpoint of the establishment of one straight-line flow to the palmar arch. All patients had end-stage renal disease requiring chronic hemodialysis. The target vessels were the ulnar artery in four cases, the radial artery in one, and the palmar arch in two. Four cases had a stenotic lesion and one had chronic total occlusion. Technical success was achieved in all cases without complications, and skin perfusion pressure of the hand improved significantly from 39 ± 20 to 52 ± 16 (P = 0.019) on the palmar side and from 40 ± 18 to 60 ± 29 on the dorsal side (P = 0.046). Clinical success was achieved in all cases during a mean follow-up period of 11 ± 8 (2-19) months.
CONCLUSIONS: Percutaneous angioplasty using contemporary dedicated devices could be a potentially useful option for CHI patients with isolated distal upper extremity artery disease.
Authors:
Osami Kawarada; Yoshiaki Yokoi; Akihiro Higashimori
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  76     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-14     Completed Date:  2011-01-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  345-50     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Kishiwada Tokushukai Hospital, Kishiwada-City, Osaka, Japan. kawarada90@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Balloon / instrumentation*
Arterial Occlusive Diseases / complications,  physiopathology,  radiography,  therapy*
Catheters*
Constriction, Pathologic
Critical Illness
Equipment Design
Hand / blood supply*
Humans
Ischemia / etiology,  physiopathology,  radiography,  therapy*
Kidney Failure, Chronic / complications,  therapy
Male
Middle Aged
Radial Artery* / physiopathology,  radiography
Regional Blood Flow
Renal Dialysis
Treatment Outcome
Ulnar Artery* / physiopathology,  radiography
Comments/Corrections
Comment In:
Catheter Cardiovasc Interv. 2010 Sep 1;76(3):351   [PMID:  20839346 ]

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