PMC7775664_01
Ischemia of the left hand fingers 72 h after intra-arterial drug injection (A) prone position, (B) supine position and (C) after amputations.
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fig1
Left hand examination revealed the following injuries: cyanosis and coldness of the intermediate and distal phalanges of the fifth finger, necrosis of the distal phalanges of the second, third and fourth fingers, phlyctens of the intermediate phalanges of the second, third and fourth fingers and the proximal phalanges of the fourth finger (Figures 1A,B). Management by an orthopedic surgical team specialized in the upper limb and hand was required for the amputation of the intermediate and distal phalanges of the three fingers involved (Figure 1C).
Digital subtracted arteriography of the left hand showing occlusion of the distal portion of the radial artery and of all interdigital arteries of the second, third, fourth and fifth fingers at an early arterial phase (left panel) and late arterial phase (right panel).
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fig2
A digital subtraction angiography was rapidly performed which demonstrated no run-off in the digital arteries of the second, third and fourth left fingers (Figure 2).
Timeline summary.
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fig3
Figure 3 presents a timeline summary.