Skip to main content

Reoperative Indications in Vascular Disorders of the Hand

  • Chapter
  • First Online:
Reoperative Hand Surgery

Abstract

Fortunately in most cases of vascular or microvascular intervention, once the vessels have healed, the chances of needing repair are small. However, in some cases such as traumatic events, the vessels may thrombose or otherwise fail in the postoperative period. In these cases, reoperation is sometimes needed and is usually done in a very expeditious manner. Other cases relate to chronic vascular disease. In these cases, sympathetectomy sometimes may be of benefit. In other cases, a vascular access procedure may be stealing or shunting blood away from the hand resulting in ischemia. In these cases, revision options are sometimes needed in order to help the patient with their symptoms. Microvascular surgery requires not only a steady hand but also a steady mind, and these cases can be quite challenging.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Pasch AR, Bishara RA, Lim LT, Meyer JP, Schuler JJ, Flanigan DP. Optimal limb salvage in penetrating civilian vascular trauma. J Vasc Surg. 1986;3:189–95.

    PubMed  CAS  Google Scholar 

  2. Borman KR, Snyder III WH, Weigelt JA. Civilian arterial trauma of the upper extremity. An 11 year experience in 267 patients. Am J Surg. 1984;148:796–9.

    Article  PubMed  CAS  Google Scholar 

  3. Gelberman RH, Nunley JA, Koman LA, Gould JS, Hergenroeder PT, MacClean CR, Urbaniak JR. The results of radial and ulnar arterial repair in the forearm. Experience in three medical centers. J Bone Joint Surg Am. 1982;64:383–7.

    PubMed  CAS  Google Scholar 

  4. Wheatley MJ, Swift R. Successful hand revascularization with urokinase following a crush injury. Ann Plast Surg. 1997;39:94–6.

    Article  PubMed  CAS  Google Scholar 

  5. Harris RW, Schneider PA, Andros G, Oblath RW, Salles-Cunha S, Dulawa L. Allograft vein bypass: is it an acceptable alternative for infrapopliteal revascularization? J Vasc Surg. 1993;18:553–9.

    Article  PubMed  CAS  Google Scholar 

  6. Lauterbach SR, Torres GA, Andros G, Oblath RW. Infragenicular polytetrafluoroethylene bypass with distal vein cuffs for limb salvage: a contemporary series. Arch Surg. 2005;140:487–93.

    Article  PubMed  Google Scholar 

  7. De MD, Fritsche E, Rigoni G, Schlunke S, Von WU. Hypothenar hammer syndrome. Retrospective study of nine cases. J Hand Surg Br. 1999;24:731–4.

    Article  Google Scholar 

  8. Troum SJ, Floyd III WE, Sapp J. Ulnar artery thrombosis: a 6-year experience. J South Orthop Assoc. 2001;10:147–54.

    PubMed  CAS  Google Scholar 

  9. McNamara MG, Butler TE, Sanders WE, Pederson WC. Ischaemia of the index finger and thumb secondary to thrombosis of the radial artery in the anatomical snuffbox. J Hand Surg Br. 1998;23:28–32.

    Article  PubMed  CAS  Google Scholar 

  10. Richards RR, Urbaniak JR. Spontaneous retrocarpal radial artery thrombosis: a report of two cases. J Hand Surg Am. 1984;9:823–7.

    PubMed  CAS  Google Scholar 

  11. Chloros GD, Lucas RM, Li Z, Holden MB, Koman LA. Post-traumatic ulnar artery thrombosis: outcome of arterial reconstruction using reverse interpositional vein grafting at 2 years minimum follow-up. J Hand Surg Am. 2008;33:932–40.

    Article  PubMed  Google Scholar 

  12. Fitridge RA, Raptis S, Miller JH, Faris I. Upper extremity arterial injuries: experience at the Royal Adelaide Hospital, 1969 to 1991. J Vasc Surg. 1994;20:941–6.

    Article  PubMed  CAS  Google Scholar 

  13. Ruch DS, Aldridge M, Holden M, Smith TL, Koman LA, Smith BP. Arterial reconstruction for radial artery occlusion. J Hand Surg Am. 2000;25:282–90.

    Article  PubMed  CAS  Google Scholar 

  14. Dethmers RS, Houpt P. Surgical management of hypothenar and thenar hammer syndromes: a retrospective study of 31 instances in 28 patients. J Hand Surg Br. 2005;30:419–23.

    Article  PubMed  CAS  Google Scholar 

  15. Smith HE, Dirks M, Patterson RB. Hypothenar hammer syndrome: distal ulnar artery reconstruction with autologous inferior epigastric artery. J Vasc Surg. 2004;40:1238–42.

    Article  PubMed  Google Scholar 

  16. Dorweiler B, Neufang A, Schmiedt W, Hessmann MH, Rudig L, Rommens PM, Oelert H. Limb trauma with arterial injury: long-term performance of venous interposition grafts. Thorac Cardiovasc Surg. 2003;51:67–72.

    Article  PubMed  CAS  Google Scholar 

  17. Higgs PE, Weeks PM. Traumatic pseudoaneurysm in an ulnar artery vein graft. Plast Reconstr Surg. 1993;91:726–8.

    Article  PubMed  CAS  Google Scholar 

  18. Culp RW. Complications of wrist arthroscopy. Hand Clin. 1999;15:529–35; x.

    Google Scholar 

  19. Marecek GS, Saltzman MD, Johnson DL. Complications in shoulder arthroscopy. Orthopedics. 2010;33:492–7.

    Article  PubMed  Google Scholar 

  20. De SL. Pitfalls in wrist arthroscopy. Acta Orthop Belg. 2002;68:325–9.

    Google Scholar 

  21. Rocchi L, Canal A, Pelaez J, Fanfani F, Catalano F. Results and complications in dorsal and volar wrist Ganglia arthroscopic resection. Hand Surg. 2006;11:21–6.

    Article  PubMed  CAS  Google Scholar 

  22. Brzezinski M, Luisetti T, London MJ. Radial artery cannulation: a comprehensive review of recent anatomic and physiologic investigations. Anesth Analg. 2009;109:1763–81.

    Article  PubMed  Google Scholar 

  23. Sfeir R, Khoury S, Khoury G, Rustum J, Ghabash M. Ischaemia of the hand after radial artery monitoring. Cardiovasc Surg. 1996;4:456–8.

    Article  PubMed  CAS  Google Scholar 

  24. Valentine RJ, Modrall JG, Clagett GP. Hand ischemia after radial artery cannulation. J Am Coll Surg. 2005;201:18–22.

    Article  PubMed  Google Scholar 

  25. Wallach SG. Cannulation injury of the radial artery: diagnosis and treatment algorithm. Am J Crit Care. 2004;13:315–9.

    PubMed  Google Scholar 

  26. Wheatley MJ, Marx MV. The use of intra-arterial urokinase in the management of hand ischemia secondary to palmar and digital arterial occlusion. Ann Plast Surg. 1996;37:356–62.

    Article  PubMed  CAS  Google Scholar 

  27. Witz M, Sagiv P, Lehmann JM. Fibrinolytic treatment of acute arterial occlusion distal to the wrist in two cases. J Hand Surg Eur Vol. 2008;33:342–4.

    Article  PubMed  CAS  Google Scholar 

  28. Warren JA, Agarwal G, Wynn JJ. Arterial revascularization for upper extremity ischemia in patients with chronic kidney disease. Am Surg. 2009;75:848–52.

    PubMed  Google Scholar 

  29. Chang BB, Roddy SP, Darling III RC, Maharaj D, Paty PS, Kreienberg PB, Ozsvath KJ, Mehta M, Shah DM. Upper extremity bypass grafting for limb salvage in end-stage renal failure. J Vasc Surg. 2003;38:1313–5.

    Article  PubMed  Google Scholar 

  30. Hughes K, Hamdan A, Schermerhorn M, Giordano A, Scovell S, Pomposelli Jr F. Bypass for chronic ischemia of the upper extremity: results in 20 patients. J Vasc Surg. 2007;46:303–7.

    Article  PubMed  Google Scholar 

  31. Pederson WC. Management of end-stage ischemia of the arm. Clin Plast Surg. 1997;24:107–20.

    PubMed  CAS  Google Scholar 

  32. Bozkurt AK, Besirli K, Koksal C, Sirin G, Yuceyar L, Tuzun H, Sayin AG. Surgical treatment of Buerger’s disease. Vascular. 2004;12:192–7.

    PubMed  Google Scholar 

  33. Bhat MA, Zaroo MI, Darzi MA. Omental transplantation for critical limb ischemia in Buerger’s disease. Plast Reconstr Surg. 2007;119:1979–80.

    Article  PubMed  CAS  Google Scholar 

  34. Agarwal VK. Long-term results of omental transplantation in chronic occlusive arterial disease (Buerger’s disease). Int Surg. 2005;90:167–74.

    PubMed  Google Scholar 

  35. Matoba S, Tatsumi T, Murohara T, Imaizumi T, Katsuda Y, Ito M, Saito Y, Uemura S, Suzuki H, Fukumoto S, Yamamoto Y, Onodera R, Teramukai S, Fukushima M, Matsubara H. Long-term clinical outcome after intramuscular implantation of bone marrow mononuclear cells (therapeutic angiogenesis by cell transplantation [TACT] trial) in patients with chronic limb ischemia. Am Heart J. 2008;156:1010–8.

    Article  PubMed  Google Scholar 

  36. Motukuru V, Suresh KR, Vivekanand V, Raj S, Girija KR. Therapeutic angiogenesis in Buerger’s disease (thromboangiitis obliterans) patients with critical limb ischemia by autologous transplantation of bone marrow mononuclear cells. J Vasc Surg. 2008;48:53S–60S.

    Article  PubMed  Google Scholar 

  37. Pederson WC. Surgical techniques for revascularization in the chronically ischemic hand. Tech Hand Upper Extrem Surg. 1997;1:103–15.

    Article  CAS  Google Scholar 

  38. Chloros GD, Li Z, Koman LA. Long-term successful outcome of severe hand ischemia using arterialization with reversal of venous flow: case report. J Hand Surg Am. 2008;33:1048–51.

    Article  PubMed  Google Scholar 

  39. Kind GM. Arterialization of the venous system of the hand. Plast Reconstr Surg. 2006;118:421–8.

    Article  PubMed  CAS  Google Scholar 

  40. King TA, Marks J, Berrettoni BA, Seitz WH. Arteriovenous reversal for limb salvage in unreconstructible upper extremity arterial occlusive disease. J Vasc Surg. 1993;17:924–32.

    Article  PubMed  CAS  Google Scholar 

  41. Sasajima T, Azuma N, Uchida H, Asada H, Inaba M, Akasaka N. Combined distal venous arterialization and free flap for patients with extensive tissue loss. Ann Vasc Surg. 2010;24:373–81.

    Article  PubMed  Google Scholar 

  42. Hartzell TL, Makhni EC, Sampson C. Long-term results of periarterial sympathectomy. J Hand Surg Am. 2009;34:1454–60.

    Article  PubMed  Google Scholar 

  43. Malik J, Tuka V, Kasalova Z, Chytilova E, Slavikova M, Clagett P, Davidson I, Dolmatch B, Nichols D, Gallieni M. Understanding the dialysis access steal syndrome. A review of the etiologies, diagnosis, prevention and treatment strategies. J Vasc Access. 2008;9:155–66.

    PubMed  CAS  Google Scholar 

  44. Berman SS, Gentile AT, Glickman MH, Mills JL, Hurwitz RL, Westerband A, Marek JM, Hunter GC, McEnroe CS, Fogle MA, Stokes GK. Distal revascularization-interval ligation for limb salvage and maintenance of dialysis access in ischemic steal syndrome. J Vasc Surg. 1997;26:393–402.

    Article  PubMed  CAS  Google Scholar 

  45. Knox RC, Berman SS, Hughes JD, Gentile AT, Mills JL. Distal revascularization-interval ligation: a durable and effective treatment for ischemic steal syndrome after hemodialysis access. J Vasc Surg. 2002;36:250–5.

    Article  PubMed  Google Scholar 

  46. Jones NF. Ischemia of the hand in systemic disease. The potential role of microsurgical revascularization and digital sympathectomy. Clin Plast Surg. 1989;16:547–56.

    PubMed  CAS  Google Scholar 

  47. Balogh B, Mayer W, Vesely M, Partsch H, Piza-Katzer H. Periarterial sympathectomy of the radial and ulnar arteries in Raynaud’s phenomenon—a preliminary study. Handchir Mikrochir Plast Chir. 2002;34:374–80.

    Article  PubMed  CAS  Google Scholar 

  48. Li Z, Smith BP, Holden M, Koman LA. Periarterial sympathectomy of the foot for the treatment of necrotizing Raynaud’s phenomena. J Reconstr Microsurg. 2009;25:133–7.

    Article  PubMed  CAS  Google Scholar 

  49. el-Gammal TA, Blair WF. Digital periarterial sympathectomy for ischaemic digital pain and ulcers. J Hand Surg Br. 1991;16:382–5.

    Article  PubMed  CAS  Google Scholar 

  50. Henry M, Levaro F, Masson M. Periarterial sympathectomy salvage of the acutely ischemic hand. J Reconstr Microsurg. 2003;19:7–10.

    Article  PubMed  Google Scholar 

  51. Dorafshar AH, Seitz IA, Zachary L. Reoperative digital sympathectomy in refractory Raynaud’s phenomenon. Plast Reconstr Surg. 2009;123:36e–8e.

    Article  PubMed  Google Scholar 

  52. Leriche R. Sympathetic effect in vascular diseases of the extremities. Dia Med. 1957;29:3031–3.

    PubMed  CAS  Google Scholar 

  53. Zook EG, Kleinert HE, Van Beek AL. Treatment of the ischemic finger secondary to digital artery occlusion. Plast Reconstr Surg. 1978;62:229–34.

    Article  PubMed  CAS  Google Scholar 

  54. Haerle M, Tonagel F, Schaller HE. Collateral arterial pathways in the forearm. Surg Radiol Anat. 2004;26:208–11.

    Article  PubMed  CAS  Google Scholar 

  55. Fregene A, Ditmars D, Siddiqui A. Botulinum toxin type A: a treatment option for digital ischemia in patients with Raynaud’s phenomenon. J Hand Surg Am. 2009;34:446–52.

    Article  PubMed  Google Scholar 

  56. Neumeister MW, Chambers CB, Herron MS, Webb K, Wietfeldt J, Gillespie JN, Bueno Jr RA, Cooney CM. Botox therapy for ischemic digits. Plast Reconstr Surg. 2009;124:191–201.

    Article  PubMed  CAS  Google Scholar 

  57. Sycha T, Graninger M, Auff E, Schnider P. Botulinum toxin in the treatment of Raynaud’s phenomenon: a pilot study. Eur J Clin Invest. 2004;34:312–3.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to William C. Pederson MD, FACS .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Pederson, W.C. (2012). Reoperative Indications in Vascular Disorders of the Hand. In: Duncan, S. (eds) Reoperative Hand Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-2373-7_7

Download citation

  • DOI: https://doi.org/10.1007/978-1-4614-2373-7_7

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-2372-0

  • Online ISBN: 978-1-4614-2373-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics