Document Detail


A systematic approach to severe hand ischemia.
MedLine Citation:
PMID:  339388     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
M F McNamara; H S Takaki; J S Yao; J J Bergan
Related Documents :
8497608 - Atherosclerotic occlusive disease of the lower extremity: prospective evaluation with t...
15513298 - Fatality of myocardial infarction in relation to the coronary anatomy: role of culprit ...
20595858 - Detection of flap venous and arterial occlusion using interstitial glucose monitoring i...
13638838 - Cerebral vascular occlusion; angiographic diagnosis.
7303048 - Transient ischemic attacks and external carotid artery. a retrospective study of 23 pat...
18753698 - Tissue characterization of coronary plaques: comparison of integrated backscatter intra...
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Surgery     Volume:  83     ISSN:  0039-6060     ISO Abbreviation:  Surgery     Publication Date:  1978 Jan 
Date Detail:
Created Date:  1978-02-23     Completed Date:  1978-02-23     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1-11     Citation Subset:  AIM; IM    
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
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:
9004-54-0/Dextrans; 9005-49-6/Heparin

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


Previous Document:  The Institute of Ophthalmology of the University of London.
Next Document:  Familial cancer: implications for surgical management of high-risk patients.