| A systematic approach to severe hand ischemia. | |
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MedLine Citation:
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PMID: 339388 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Because severely symptomatic hand ischemia is not common and because there are a wide variety of clinical conditions which can cause arterial insufficiency of the upper extremity, a retrospective study has been done to determine the efficacy of various diagnostic manipulations used in managing 65 patients with severe hand ischemia at the Northwestern University McGaw Medical Center, Traumatic, thermal, and iatrogenic causes of hand ischemia were diagnosed by simple history taking, as was advanced uremic arteritis. Doppler ultrasound and digital arterial pressure recording were confirmative, rather than diagnostic. These aided in defining precise degrees of ischemia and identifying proximal arterial occlusions. Invasive total extremity angiography clarified atherosclerotic, atheroembolic, and other chronic occlusive lesions while serum electrophoresis and immunoelectrophoresis defined the polyclonal and monoclonal gammopathies. When digital necrosis was present, organic arterial occlusions usually were found. These responded best to direct arterial reconstruction down to the mid-palm level. Transpleural, transthoracic sympathectomy was useful as an adjuvant or as definitive treatment for distal digital arterial occlusions. Selective vasodilator therapy was used as dictated by the cause of ischemia and its eventual outcome. |
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Authors:
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M F McNamara; H S Takaki; J S Yao; J J Bergan |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Surgery Volume: 83 ISSN: 0039-6060 ISO Abbreviation: Surgery Publication Date: 1978 Jan |
Date Detail:
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Created Date: 1978-02-23 Completed Date: 1978-02-23 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0417347 Medline TA: Surgery Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1-11 Citation Subset: AIM; IM |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Adult Aged Angiography Dextrans / therapeutic use Female Hand / blood supply* Heparin / therapeutic use Humans Ischemia / diagnosis, etiology*, therapy Male Medical History Taking Middle Aged Physical Examination Retrospective Studies Ultrasonography |
| Chemical | |
Reg. No./Substance:
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9004-54-0/Dextrans; 9005-49-6/Heparin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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