| 3 cases of hand ischemia associated with radial artery occlusion in the first web space. |
| Click on each image for a larger picture |
| Case 1. |
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| Case 2: more severe problem: ulnar artery is occluded as well. This patient signed out of the ICU AMA to have a smoke (5 pack a day - yeeow!) |
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| Case 2: The problem with revascularisation at this location is that the distal point of occlusion is at a branch - usually at a fork between the thumb and the palmar arch. Ideally, a distally branching reversed vein graft can supply both points, as was done here (vein graft, dorsal approach to first web space, distal left, thumb superior). |
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| Case 3: More focal problem, thumb and index ischemia: Arteriogram: |
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| Case 3: I think that this tight fascial band in the FDIO (Littlers under the left, artery visible to the right) contributed mechanically. |
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| Case 3: Again, a distally branching vein graft to reconstruct inflow to both thumb and palmar arch. |
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retrocarpal radial artery digital artery emboli finger revascularization |
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