L'ischémie digitale aiguë : une urgence microchirurgicale

Schoofs, M.; Leps, P.; l'Aulnoit, S Houzé de; Auvray, G

doi:10.1016/s0294-1260(01)00003-6

Cited by 2 publications

(6 citation statements)

References 8 publications

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“…As for treatment, our study was consistent with other studies in literature [25–29] . Iloprost is frequently used in UEDI due to SSc and Bosentan has proven efficiency to prevent recurrence of UEDI due to SSc [25–27] .…”

Section: Discussionsupporting

confidence: 89%

“…[28,29] The surgical studies both recommend anticoagulant therapy after surgery which is consistent with our study where anticoagulant therapy was more often used in DICE. [28][29][30] This study has several limits; patients were included retrospectively during a significant period of 16 years and so there has been data loss. For idiopathic cases, we managed to find bloods tests results in 92.5% of the cases and morphological tests results in 86.6%.…”

Section: Discussionsupporting

confidence: 87%

“…As for treatment, our study was consistent with other studies in literature. [25][26][27][28][29] Iloprost is frequently used in UEDI due to SSc and Bosentan has proven efficiency to prevent recurrence of UEDI due to SSc. [25][26][27] In our study, we did not include treatment with phosphodiesterase inhibitors as it was still in the test during this period.…”

Section: Discussionmentioning

confidence: 99%

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Digital ischaemia aetiologies and mid-term follow-up

Raimbeau¹,

Pistorius²,

Gouëffic³

et al. 2021

Medicine

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Upper extremity digital ischaemia (UEDI) is a rare heterogeneous condition whose frequency is 40 times less than that of toe ischaemia. Using a large cohort, the aim of this study was to evaluate aetiologies, prognosis and midterm clinical outcomes of UEDI. All patients with UEDI with or without cutaneous necrosis in a university hospital setting between January 2000 to December 2016 were included. Aetiologies, recurrence of UEDI, digital amputation and survival were analyzed retrospectively. Three hundred twenty three patients were included. UEDI due to cardio-embolic disease (DICE) was the highest occurring aetiology with 59 patients (18.3%), followed by DI due to Systemic Sclerosis (SSc) (16.1%), idiopathic causes (11.7%), Thromboangiitis obliterans (TAO) (9.3%), iatrogenic causes (9.3%), and cancer (6.2%). DICE patients tended to be older and featured more cases with arterial hypertension whereas TAO patients smoked more tobacco and cannabis. During follow-up, recurrences were significantly more frequent in SSc than in all other tested groups ( P < .0001 vs idiopathic and DICE, P = .003 vs TAO) and among TAO patients when compared to DICE patients ( P = .005). The cumulated rate of digital amputation was higher in the SSc group (n = 18) ( P = .02) and the TAO group (n = 7) ( P = .03) than in DICE (n = 2). This retrospective study suggests that main aetiologies of UEDI are DICE, SSc and idiopathic. This study highlights higher frequency of iatrogenic UEDI than previous studies. UEDI associated with SSc has a poor local prognosis (amputations and recurrences) and DICE a poor survival. UEDI with SSc and TAO are frequently recurrent.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Digital ischaemia aetiologies and mid-term follow-up

Raimbeau¹,

Pistorius²,

Gouëffic³

et al. 2021

Medicine

View full text Add to dashboard Cite

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“…25 Hendrickson, 26 Nakamura,27 and Neill-cage 28 have also described this pathology in athletes and we earlier underlined the great incidence of HHS in skaters. 9 Recently, Sadat 29 pointed out the role of physiotherapy as a cause of hypothenar hammer syndrome. Finally, an aberrant course of a communicating branch of the ulnar nerve to the median nerve may also lead to HHS.…”

Section: Discussionmentioning

confidence: 99%

“…45 Finally, embolization by lead-shot, iatrogenous embolization by injection, metastases, or acute embolisms due to artery inflammation should stay in mind. 9,46 The embolectomy is possible until superficial palmar arch with a Fogarty's catheter. 1,7 Distally, the microsurgeon should distinguish the palmar arch, the common digital vessels so as the minor and major digital pedicle.…”

Section: Discussionmentioning

confidence: 99%

Acute digital ischemia: A neglected microsurgical emergency. Report of 17 patients and literature review

2009

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This study was performed to review our 16-year experience in acute finger ischemia. A review of the literature was also performed. A retrospective chart review of 17 patients, 14 men and 3 women, was conducted. Etiologies were ulnar aneurysm in 11 cases, atrial fibrillation in five cases and thoracic outlet syndrome in one case. Upto the palmar superficial arch, embolus due to atrial fibrillation or thoracic outlet syndrome could be loosened by a Fogarty catheter. In cases of aneurysm of the ulnar artery, we performed each time an aneurysm resection followed by direct anastomose alone, while three patients had additional grafts: artery graft (epigastric artery) or reversed vein grafts (superficial forearm vein). Microsurgical dissection of the digital collateral arteries enabled us to perform a thrombectomy. The transversal arteriotomies were closed after the collateral arteries were washed. The immediate perfusion of digit after the reconstruction of the aneurysm was each time excellent. The disoccluded vessels, investigated by Allen testing and Doppler ultrasound, were all patents. Two patients suffered from a small ulcer of the small fingertip that disappeared after 2 weeks. One patient had a 30 degrees ischemic flexion contracture in the metacarpophalangeal joint and 25 degrees flexion contracture in the proximal interphalangeal joint of the third digit. With regards to long-term outcomes, no secondary amputations were necessary and there was no recurrence after a mean follow-up of 10.7 years. Diagnostic of acute digital ischemia is often neglected. An early recognition and an aggressive microsurgical treatment are necessary to ensure low morbidity.

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L'ischémie digitale aiguë : une urgence microchirurgicale

Cited by 2 publications

References 8 publications

Digital ischaemia aetiologies and mid-term follow-up

Digital ischaemia aetiologies and mid-term follow-up

Acute digital ischemia: A neglected microsurgical emergency. Report of 17 patients and literature review

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