title: Anatomic and physiologic evaluation of upper extremity ischemia.
abstract: This study assessed the accuracy of arteriography and laser Doppler perfusion imaging (LDPI) as predictors of digital ischemia and correlated upper extremity symptoms, function, and nutritional flow with arteriographic and laser Doppler assessments. Multiple-level occlusive disease was documented in 25 hands (23 patients) by arteriography. LDPI demonstrated one or more hypoperfused digits in 17 hands. Patient questionnaires were used to assess upper extremity symptoms, pain, cold sensitivity, and function. Spearman correlation coefficients indicated that arteriography is a poor indicator of nutritional perfusion as measured by LDPI. Neither arteriography or laser Doppler perfusion imaging served as an indicator of the severity of cold intolerance. However, upper extremity symptoms and functional status correlated with both laser Doppler measurements and the level of cold sensitivity. Laser Doppler perfusion imaging and arteriographic analysis provide complimentary data in the evaluation of upper extremity ischemia.
authors.affiliation: Department of Orthopaedic Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157-1070, USA.
authors.forename: D S
authors.initials: DS
authors.lastname: Ruch
authors.forename: T L
authors.initials: TL
authors.lastname: Smith
authors.forename: B P
authors.initials: BP
authors.lastname: Smith
authors.forename: M
authors.initials: M
authors.lastname: Holden
authors.forename: G
authors.initials: G
authors.lastname: Russell
authors.forename: L A
authors.initials: LA
authors.lastname: Koman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000792:Angiography; D001132:Arm / Q000098:blood supply*; D003080:Cold Temperature; D005260:Female; D006225:Hand / Q000098:blood supply; D006801:Humans; D007511:Ischemia / Q000175:diagnosis* / Q000503:physiopathology; D017078:Laser-Doppler Flowmetry; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow