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Angioplasty of ulnar or radial arteries to treat critical hand ischemia: Use of 3‐ and 4‐French Systems
Author(s) -
Kawarada Osami,
Yokoi Yoshiaki,
Higashimori Akihiro
Publication year - 2010
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.22545
Subject(s) - medicine , ulnar artery , radial artery , angioplasty , critical limb ischemia , surgery , dialysis , percutaneous , ischemia , catheter , balloon , radiology , artery , cardiology , vascular disease , arterial disease
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. © 2010 Wiley‐Liss, Inc.