Angioplasty of Ulnar or Radial Arteries to Treat Critical Hand Ischemia: Use of 3- and 4-French Systems

作者：Kawarada Osami^*; Yokoi Yoshiaki; Higashimori Akihiro

来源：Catheterization and Cardiovascular Interventions, 2010, 76(3): 345-350.

DOI：10.1002/ccd.22545

• endovascular treatment
• critical limb ischemia
• upper extremity

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.

• 出版日期2010-9-1