Chronic Upper Extremity Arterial Insufficiency

Gross, William S.; Flanigan, D. Preston; Kraft, Richard O.; Stanley, James C.

doi:10.1001/archsurg.1978.01370160077012

Cited by 62 publications

(3 citation statements)

References 20 publications

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“…Although still untested clinically, sympathectomy may prove to be an important complement to arterial reconstruction in treating patients with impaired forearm runoff because of severe occlusive disease. 22 '49 In our case, the patient who was treated with cervicodorsal sympathectomy had nearly complete relief of symptoms, with a light, residual forearm claudication.…”

Section: Discussionmentioning

confidence: 56%

Brachial Artery Revascularization Following Cardiac Catherization

Cistemino¹,

Schultz²,

Feldhaus³

et al. 1990

Vascular Surgery

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From January, 1973, to December, 1987, 63 arterial revascularization procedures were performed in 50 patients suffering from brachial artery injuries following cardiac catheterization. There were 15 occlusive complications (30%) after the primary attempt to revascularize the damaged brachial artery. Thrombectomy associated with a simple repair of the arterial cutdown (Type IA) led to 8 complications of 9 procedures performed. Technical details of repair of the damaged artery—debridement, venous patch graft, resection, end-to-end anastomosis, and venous bypass interposition—were found to be important and led to long-term patency.

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Section: Discussionmentioning

confidence: 56%

Brachial Artery Revascularization Following Cardiac Catherization

Cistemino¹,

Schultz²,

Feldhaus³

et al. 1990

Vascular Surgery

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“…Conversely, a digital brachial index above 0.7 is indicative of adequate blood flow (Zimmerman, 1994). It is unclear why the clinically-accepted threshold has been set to 0.7; however, it was likely influenced by the study of Gelberman et al (1978) and Gross et al (1978). Gelberman studied a group of patients with replanted digits, and observed that all patients with a digital pulse pressure that was less than 75% of the contralateral side suffered from severe cold intolerance (Gelberman, 1978).…”

Section: Chronic Rejectionmentioning

confidence: 99%

“…Gelberman studied a group of patients with replanted digits, and observed that all patients with a digital pulse pressure that was less than 75% of the contralateral side suffered from severe cold intolerance (Gelberman, 1978). While Gross et al reported that patients with a segmental pressure of 63% or less on the contralateral side suffered from forearm claudication (Gross, 1978). Zimmerman et al (1994) used 0.7 as a midway between these two studies to guide their choice between ligation or reconstruction of the ulnar artery in patients with ulnar artery occlusion.…”

Section: Chronic Rejectionmentioning

confidence: 99%

Investigation of high-frequency ultrasound biomicroscopy for examining arteriopathy in hand transplant patients.

Cox

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The fourth hand transplant recipient in Louisville lost his graft at nine months post transplant from ischemia due to severe graft arteriopathy. Conventional imaging techniques and clinical measurements, including CT angiography and measurements of brachial indices via ultrasound, did not indicate that the patient was in such a severe condition in the days prior to amputation. Histological analysis of tissue from the amputated graft revealed massive intimal hyperplasia, a hallmark of chronic rejection. The purpose of this study was to describe a method to allow non-invasive monitoring of wall thicknesses in the radial, ulnar, palmar arch, and digital arteries of the transplanted hand. A novel ultrasound biomicroscopy unit (Vevo 2100) was used to image the blood vessels of the transplanted and native hands in four hand transplant recipients, ranging from 16 months to 11 years post transplant. The unit has a potential resolution of 30 µm, which allowed measurement of the intima and media layers of the arteries. The intima, media, and lumen measurements were compared in the native and transplanted hand in all four patients. Significant increases in intima thickness were found in the transplanted hands. In addition, the transplanted hand had significantly higher intima to lumen diameter ratios. From Doppler waveforms, it was found that that peak velocities were lower in the transplanted hand. Finally, hoop stress calculations revealed that the hoop stress seen in the arterial walls was lower in the transplanted hand. The ultrasound biomicroscopy unit provided an accurate, repeatable, and realtime method to investigate the arteriopathy of hand transplant patients. In the future, it vi will provide a way for clinicians to monitor the progression of arteriopathy in the hand, including intimal hyperplasia. vii

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Obliterative Arterial Disease of the Upper Extremity

Welling¹

1981

Arch Surg

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Chronic Upper Extremity Arterial Insufficiency

Cited by 62 publications

References 20 publications

Brachial Artery Revascularization Following Cardiac Catherization

Brachial Artery Revascularization Following Cardiac Catherization

Investigation of high-frequency ultrasound biomicroscopy for examining arteriopathy in hand transplant patients.

Obliterative Arterial Disease of the Upper Extremity

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