title: Sildenafil as a therapeutic option for digital ischemic ulceration: case report.
abstract: We report the case of a 37-year-old woman who developed critical upper limb ischemia caused by a cervical rib. Because the malformation was initially undiagnosed, a vascular bypass was performed, and failure occurred. Following a 6-month therapy with sildenafil, revascularization of the arm was successful and amputation was avoided. A 6-year follow-up shows a rich collateral network at the compression site and normal values of digital plethysmography. Because hand surgeons often see patients with digital ulcerations and other manifestations of peripheral vascular pathology, therapy of ischemia with sildenafil could be an effective treatment option in patients not responding to classic drugs.
authors.affiliation: Plastic, Reconstructive and Hand Surgery Department, Lausanne University Hospital, Lausanne, Switzerland; Angiology Department, Lausanne University Hospital, Lausanne, Switzerland; Radiology Department, Lausanne University Hospital, Lausanne, Switzerland; Radiology Department, Antwerp University Hospital, Edegem, Belgium. Electronic address: Swenn.Krahenbuhl@gmail.com.
authors.forename: Swenn Maxence
authors.initials: SM
authors.lastname: Krähenbühl
authors.affiliation: Plastic, Reconstructive and Hand Surgery Department, Lausanne University Hospital, Lausanne, Switzerland; Angiology Department, Lausanne University Hospital, Lausanne, Switzerland; Radiology Department, Lausanne University Hospital, Lausanne, Switzerland; Radiology Department, Antwerp University Hospital, Edegem, Belgium.
authors.forename: Michele
authors.initials: M
authors.lastname: Depairon
authors.affiliation: Plastic, Reconstructive and Hand Surgery Department, Lausanne University Hospital, Lausanne, Switzerland; Angiology Department, Lausanne University Hospital, Lausanne, Switzerland; Radiology Department, Lausanne University Hospital, Lausanne, Switzerland; Radiology Department, Antwerp University Hospital, Edegem, Belgium.
authors.forename: Marguerite
authors.initials: M
authors.lastname: Faure
authors.affiliation: Plastic, Reconstructive and Hand Surgery Department, Lausanne University Hospital, Lausanne, Switzerland; Angiology Department, Lausanne University Hospital, Lausanne, Switzerland; Radiology Department, Lausanne University Hospital, Lausanne, Switzerland; Radiology Department, Antwerp University Hospital, Edegem, Belgium.
authors.forename: Naik
authors.initials: N
authors.lastname: Vietti Violi
authors.affiliation: Plastic, Reconstructive and Hand Surgery Department, Lausanne University Hospital, Lausanne, Switzerland; Angiology Department, Lausanne University Hospital, Lausanne, Switzerland; Radiology Department, Lausanne University Hospital, Lausanne, Switzerland; Radiology Department, Antwerp University Hospital, Edegem, Belgium.
authors.forename: Lee Ann
authors.initials: LA
authors.lastname: Applegate
authors.affiliation: Plastic, Reconstructive and Hand Surgery Department, Lausanne University Hospital, Lausanne, Switzerland; Angiology Department, Lausanne University Hospital, Lausanne, Switzerland; Radiology Department, Lausanne University Hospital, Lausanne, Switzerland; Radiology Department, Antwerp University Hospital, Edegem, Belgium.
authors.forename: Wassim
authors.initials: W
authors.lastname: Raffoul
mesh_terms: D000328:Adult; D001132:Arm / Q000098:blood supply*; D005260:Female; D006801:Humans; D007511:Ischemia / Q000188:drug therapy* / Q000209:etiology; D009336:Necrosis; D016491:Peripheral Vascular Diseases / Q000188:drug therapy* / Q000209:etiology; D000068677:Sildenafil Citrate / Q000627:therapeutic use*; D012883:Skin Ulcer / Q000188:drug therapy* / Q000209:etiology; D013901:Thoracic Outlet Syndrome / Q000150:complications*; D014665:Vasodilator Agents / Q000627:therapeutic use*
chemical_list: D014665:Vasodilator Agents; D000068677:Sildenafil Citrate
keywords: Cervical rib; digital necrosis; sildenafil; thoracic outlet syndrome; unilateral Raynaud phenomenon