PMC3819912_01
Digital involvement of the right hand 8 hours after brachial artery cannulation.
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fig1
Due to the severity of illness and need for arterial access, a decision was made to insert a right brachial artery catheter, but after 8 hours the middle, ring, and index fingers of the right hand were noted to be cold, and cyanosed, and the arterial line was immediately removed (Figure 1).
Signs of early necrosis in the finger tips.
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Ischemic changes soon became evident and 4 hours later progressed to involve the distal part of the fingers which started showing signs of probable early necrosis (Figure 2).
Resolving ischemia of the 2nd, 3rd, 4th and 5th fingers, 5 days after the ischemic event (dorsal and palmar aspects of the hand).
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By day 12, the area of ischemia was limited to the tips of the fingers, and treatment was discontinued on day 21 (Figures 3 and 4).
Residual ischemia at the tip of the middle finger after 10 days.
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By day 12, the area of ischemia was limited to the tips of the fingers, and treatment was discontinued on day 21 (Figures 3 and 4).
Complete resolution 7 weeks after the incident.
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The nail beds were intact with full restorative function of the fingers (Figure 5).