Upper extremity ischemia caused by small artery disease

• Published in: Annals of surgery Vol. 206; no. 4; pp. 521 - 528
• Main Authors: MILLS, J. L, FRIEDMAN, E. I, TAYLOR, L. M. JR, PORTER, J. M
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott 01.10.1987
• Subjects: Angiography; Arterial Occlusive Diseases - complications; Arteriosclerosis - complications; Arteriosclerosis - diagnosis; Autoimmune Diseases - complications; Autoimmune Diseases - diagnosis; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Female; Fingers - blood supply; Follow-Up Studies; Humans; Ischemia - diagnostic imaging; Ischemia - etiology; Ischemia - physiopathology; Ischemia - therapy; Male; Medical sciences; Middle Aged; Plethysmography; Prospective Studies; Skin Ulcer - etiology; Skin Ulcer - therapy; Thromboangiitis Obliterans - complications; Thromboangiitis Obliterans - diagnosis; Vasculitis, Leukocytoclastic, Cutaneous - complications; Vasculitis, Leukocytoclastic, Cutaneous - diagnosis; Human; Connective tissue disease; Cardiovascular disease; Exploration; Thromboangeitis obliterans; Chronic; Ischemia; Etiology; Atherosclerosis; Systemic disease; Arterial disease of the limb; Arterial occlusive disease; Upper limb
• ISSN: 0003-4932; 1528-1140
• DOI: 10.1097/00000658-198710000-00013

One hundred patients with ischemic finger ulceration had detailed prospective evaluation to determine the incidence of associated diseases, response to treatment, and natural history of the condition. A potentially serious associated disease was detected in each patient including autoimmune disease in 54%, Buerger's disease in 9%, arteriosclerosis obliterans in 9%, hypersensitivity angiitis in 22%, and miscellaneous diseases in 6%. Conservative treatment with soap and water scrubs, antibiotics, and local resection/debridement resulted in long-term healing without recurrence in 88% of patients. Most recurrences occurred in patients with autoimmune disease, usually scleroderma or CRST.