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.
Posted April 2013