PMC3915997_01
Baseline lesion: fourth finger distal necrosis
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DM and CHI being treated with hemodialysis referred to Department of Cardiology, Bezmialem Foundation University Hospital with digital ulceration of the left hand fourth finger. Despite appropriate anti-ischemic and antibiotherapy, an unhealing necrotic lesion with soft tissue infection of the distal part of the fourth finger persisted (Figure 1).
Left brachial angiography shows radial artery occlusion (A) without sufficient collateral flow (B)
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Preliminary arteriography, via right transfemoral approach (6F Judkins right 4.0 catheter, Medtronic Inc, Minneapolis, MN, USA) performed and confirmed a patent brachial artery with a proximal total occlusion of the radial artery and functionally occluded ulnar artery in the mid portion (Figure 2).
A, B. Balloon angioplasty of the radial artery with 2.0 mm x 80 mm x 150 mm and 2.5 mm x 100 mm x 150 mm peripheral balloons (Fox SV, Abbott Laboratories, Abbott Park, IL, USA
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Abbott Laboratories, Abbott Park, IL, USA), the lesions were dilated at high pressure (15 bar) for 5 min (Figure 3). A good final angiographic result was obtained with immediate pain relief (Figure 4).
A, B. The final angiography shows recanalization of the radial artery and deep palmar arch
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Abbott Laboratories, Abbott Park, IL, USA), the lesions were dilated at high pressure (15 bar) for 5 min (Figure 3). A good final angiographic result was obtained with immediate pain relief (Figure 4).
Two months after the procedure, almost complete healing of the fourth finger
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She was asymptomatic and the finger was almost healed at 2 month follow up (Figure 5).