Successful percutaneous angioplasty and stenting of the radial artery in a patient with chronic upper extremity ischemia and digital gangrene.
OBJECTIVE
To report percutaneous treatment of a chronic radial artery occlusion in a multimorbid patient with ischemic tissue loss.


METHODS
A 62-year-old man with multiple comorbidities, including renal failure and severe coronary artery disease, presented with painful, ulcerated lesions of his right hand. He has severe peripheral vascular disease, with a history of 4 digital amputations of the left hand, a right above-knee amputation, and a left femoral to peroneal artery bypass. Arteriography demonstrated chronic occlusion of the radial and ulnar arteries, with a patent interosseous and collateral flow to the distal radial artery filling the palmar arch. Angioplasty and stenting of the radial artery was performed, relieving the patient's symptoms and allowing the lesions to heal.


CONCLUSIONS
Percutaneous intervention can treat severe upper extremity ischemia with gangrene in patients with severe chronic ischemia and multiple comorbidities.
Dineen
Sean
S
Department of Surgery, University of Texas Southwestern, Dallas, Texas 75390, USA.
Smith
Stephen
S
Arko
Frank R
FR
D000800:Angioplasty, Balloon / Q000295:instrumentation*; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D002908:Chronic Disease; D005385:Fingers / Q000098:blood supply / Q000473:pathology*; D005734:Gangrene / Q000209:etiology / Q000628:therapy; D006801:Humans; D007511:Ischemia / Q000150:complications* / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D017534:Radial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D011859:Radiography; D015607:Stents; D016896:Treatment Outcome; D034941:Upper Extremity / Q000098:blood supply*; D014654:Vascular Patency