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 RR31. Anatomic Findings and Outcomes Associated with Arteriography and Thrombolysis for Acute Finger Ischemia

Arsalla Islam, Colston Edgerton, Jeanette S. Andrews, Matthew S. Edwards, Andrew Koman, Zhongyu Li, Matthew A. Corriere
Wake Forest School of Medicine, WInston-Salem, NC.

OBJECTIVES: Limited evidence exists for management of acute finger ischemia (AFI). We evaluated anatomic findings, procedural management and amputation-free survival in a cohort of patients with AFI.
 
METHODS: Patients undergoing angiography for AFI were identified. Data were collected from medical records, arteriograms and patient interviews. Outcomes included anatomic findings, utilization of thrombolysis, complications and amputation-free survival. Descriptive statistics and survival analysis were used to evaluate results.
 
RESULTS: Thirty-five patients (mean age 47.7; 19 women) were analyzed. Symptom duration was 1-28 days; 7 patients had gangrene. Mean follow-up was 16 months. Baseline characteristics [n(%)] included: smoking [22(65)], connective tissue disease [11(31)], and repetitive hand trauma [10(29)]. Arterial lesions were most frequently identified distal to the wrist (n=32), including 8 ulnar/radial aneurysms. Proximal lesions were less common (n=11). Of 23 patients treated with thrombolysis, 11 (47.8%) had interval anatomic improvement. 11 patients had subsequent surgical revascularization. Complications included bleeding (n=3) and pseudoaneurysm (n=1). Estimated 1- and 6-month amputation-free survival (SE) were 0.81 (0.07) and 0.78 (0.07), with no difference when stratified by use of thrombolysis.
 
CONCLUSIONS: Angiography performed for AFI frequently identifies distal occlusive disease, and selective thrombolysis may expand revascularization options.
 
AUTHOR DISCLOSURES: J. S. Andrews: Nothing to disclose; M. A. Corriere: Nothing to disclose; C. Edgerton: Nothing to disclose; M. S. Edwards: Nothing to disclose; A. Islam: Nothing to disclose; A. Koman: Nothing to disclose; Z. Li: Nothing to disclose.
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Posted April 2013


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