Document Detail


Arterial reconstruction in the ischemic hand and wrist: effects on microvascular physiology and health-related quality of life.
MedLine Citation:
PMID:  9763249     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Patients were evaluated before and after arterial reconstruction surgery (1) to define the physiology of the digital microcirculation in chronic subcritical ischemia, (2) to demonstrate the short-term effects of successful arterial reconstruction on microvascular flow, and (3) to document the effects of surgery on symptoms, function, and health-related quality of life. Arterial insufficiency was the result of a proximal reconstructible occlusive lesion, 1 or more distal unreconstructible occlusions, and secondary reactive vasospasm. Microvascular physiology was evaluated by monitoring digital temperatures, microvascular perfusion (laser Doppler fluxmetry) and perfusion patterns (laser Doppler perfusion patterns (laser Doppler perfusion imaging). Following successful vascular reconstruction, digital temperatures and microvascular perfusion improved significantly, approaching control levels. Although cold sensitivity was unchanged, symptoms decreased and upper extremity function and health-related quality of life improved after successful proximal reconstruction in patients with 2-level arterial occlusion.
Authors:
L A Koman; D S Ruch; M Aldridge; B P Smith; M B Holden; M Fulcher
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The Journal of hand surgery     Volume:  23     ISSN:  0363-5023     ISO Abbreviation:  J Hand Surg Am     Publication Date:  1998 Sep 
Date Detail:
Created Date:  1998-12-22     Completed Date:  1998-12-22     Revised Date:  2009-06-08    
Medline Journal Info:
Nlm Unique ID:  7609631     Medline TA:  J Hand Surg Am     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  773-82     Citation Subset:  IM    
Affiliation:
Department of Orthopaedic Surgery, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1070, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Analysis of Variance
Anastomosis, Surgical / methods
Cohort Studies
Female
Fingers / blood supply*
Follow-Up Studies
Hand / blood supply*
Humans
Ischemia / surgery*
Laser-Doppler Flowmetry
Male
Microcirculation / physiology
Middle Aged
Quality of Life*
Radial Artery / pathology,  surgery
Treatment Outcome
Ulnar Artery / pathology,  surgery
Vascular Patency / physiology
Vascular Surgical Procedures / methods
Wrist / blood supply*
Grant Support
ID/Acronym/Agency:
AR41765/AR/NIAMS NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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