Villacreses Camila, Wooster Mathew D
Division of Vascular Surgery, Medical University of South Carolina, Charleston, SC.
J Vasc Surg Cases Innov Tech. 2024 Mar 26;10(3):101492. doi: 10.1016/j.jvscit.2024.101492. eCollection 2024 Jun.
Limb reimplantation is widely described, but there are sparse reports of limb ischemia complications. We present the case of a patient with hand reimplantation who developed limb-threatening ischemia 20 years later. The patient is a 37-year-old man with a history of traumatic wrist amputation and reimplantation who presented with fingertip ulcerations. Testing demonstrated ischemic digit pressures and no flow in the palmar arch. The initial angiogram demonstrated radial artery occlusion. Balloon angioplasty had initial success; however, the loss of primary patency prompted repeat angiography with the use of intravascular ultrasound and laser atherectomy. His symptoms and wounds resolved, with normalized digit pressures. His radial artery remains patent after 2 years.
肢体再植已有广泛报道，但关于肢体缺血并发症的报道却很少。我们报告一例手部再植患者，20年后出现危及肢体的缺血情况。该患者为37岁男性，有创伤性腕部截肢及再植病史，因指尖溃疡前来就诊。检查显示手指缺血压力，掌弓无血流。最初的血管造影显示桡动脉闭塞。球囊血管成形术起初取得成功；然而，原发血管通畅性的丧失促使再次进行血管造影，并使用血管内超声和激光斑块切除术。他的症状和伤口得到缓解，手指压力恢复正常。两年后他的桡动脉仍保持通畅。
