Krähenbühl Swenn Maxence, Depairon Michele, Faure Marguerite, Vietti Violi Naik, Applegate Lee Ann, Raffoul Wassim
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.
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.
J Hand Surg Am. 2015 May;40(5):890-3. doi: 10.1016/j.jhsa.2015.01.041. Epub 2015 Mar 25.
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.
