Short- and long-term results with a percutaneous treatment in critical hand ischaemia

Zoltán Ruzsa, Balázs Berta, Júlia Tóth, B. Nemes, András Katona, Arthúr Hüttl, Imre Ungi, Olivier F. Bertrand, B. Merkely

Research output: Contribution to journalArticle

Abstract

Background: The aim of this prospective registry was to determine the feasibility, safety, and outcomes of percutaneous transluminal angioplasty and thrombolysis in the treatment of critical hand ischemia (CHI). Methods: One-hundred one patients (aged 60.6 ± 15.3 years) were treated for CHI between 2012 and 2016 in three cardiovascular centers. Anatomically, the upper arm was divided into three segments (I-subclavian, II-brachial, and III-forearm). We examined the rates of technical and clinical success, major adverse events (MAEs), and vascular complications at 1 year and at long-term follow-up. Results: Nineteen patients (18.8%) were treated for acute CHI, and 82 (81.2%) for chronic CHI. Median follow-up was 36.9 (19.6–68.3) months. Clinical symptoms were isolated rest pain in 91 patients (90.1%) and digital ulcer or gangrene in 10 patients (9.9%). The technical and clinical success rate of intervention was 96.0% (97/101) and 84.2% (85/101) at 1 year. Angioplasty was performed in Segments I, II, and III in 28 (27.7%), in 29 (28.7%), and 44 (43.5%) patients. Stent implantation was necessary in 47 patients (46.8%). Vascular access site complications were found in 2.1% of the sample. After 1 year, MAEs occurred in 27 patients (26.9%), and the target lesion revascularization rate was 11.9%. In two patients (1.9%), thoracic sympatectomy was necessary, and two patients (1.9%) underwent minor finger amputations. Conclusions: Angioplasty of hand vessels for CHI is a feasible and safe procedure with acceptable rates of technical success and hand healing. MAEs are frequent because the rate of severe comorbidities is high.

Original languageEnglish
JournalCatheterization and Cardiovascular Interventions
DOIs
Publication statusPublished - Jan 1 2019

    Fingerprint

Keywords

  • balloon angioplasty
  • brachial/radial/ulnar
  • catheterization
  • complications
  • vascular access

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this