Arterial reconstruction in the ischemic hand and wrist: effects on microvascular physiology and health-related quality of life

Patients were evaluated before and after arterial reconstruction surgery (1) to define the physiology of the digital microcirculation in chronic subcritical ischemia, (2) to demonstrate the short-term effects of successful arterial reconstruction on microvascular flow, and (3) to document the effect...

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Bibliographic Details
Published inThe Journal of hand surgery (American ed.) Vol. 23; no. 5; p. 773
Main Authors Koman, L A, Ruch, D S, Aldridge, M, Smith, B P, Holden, M B, Fulcher, M
Format Journal Article
LanguageEnglish
Published United States 01.09.1998
Subjects
Adult
Analysis of Variance
Anastomosis, Surgical - methods
Cohort Studies
Female
Fingers - blood supply
Follow-Up Studies
Hand - blood supply
Humans
Ischemia - surgery
Laser-Doppler Flowmetry
Male
Microcirculation - physiology
Middle Aged
Quality of Life
Radial Artery - pathology
Radial Artery - surgery
Treatment Outcome
Ulnar Artery - pathology
Ulnar Artery - surgery
Vascular Patency - physiology
Vascular Surgical Procedures - methods
Wrist - blood supply
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Summary:Patients were evaluated before and after arterial reconstruction surgery (1) to define the physiology of the digital microcirculation in chronic subcritical ischemia, (2) to demonstrate the short-term effects of successful arterial reconstruction on microvascular flow, and (3) to document the effects of surgery on symptoms, function, and health-related quality of life. Arterial insufficiency was the result of a proximal reconstructible occlusive lesion, 1 or more distal unreconstructible occlusions, and secondary reactive vasospasm. Microvascular physiology was evaluated by monitoring digital temperatures, microvascular perfusion (laser Doppler fluxmetry) and perfusion patterns (laser Doppler perfusion patterns (laser Doppler perfusion imaging). Following successful vascular reconstruction, digital temperatures and microvascular perfusion improved significantly, approaching control levels. Although cold sensitivity was unchanged, symptoms decreased and upper extremity function and health-related quality of life improved after successful proximal reconstruction in patients with 2-level arterial occlusion.
ISSN:0363-5023
DOI:10.1016/S0363-5023(98)80150-0