Hwang D, Kim HK. In Situ Bypass from the Brachial to Radial Artery in the Anatomical Snuffbox for Limb Salvage in End-Stage Renal Disease.
Vasc Specialist Int 2021;
37:40. [PMID:
34963674 PMCID:
PMC8720579 DOI:
10.5758/vsi.210056]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 10/20/2021] [Accepted: 11/11/2021] [Indexed: 12/24/2022] Open
Abstract
Diabetes and renal failure frequently involved in small vessel arteriopathy. With medical advancements, those patients survive longer with an increasing incidence of resultant arterial occlusive disease affecting the distal upper extremity (UE). In patients with ulcers or gangrene in the distal UE, bypass surgery is often complicated by severe atherosclerosis with calcification, resulting in poor distal anastomosis quality. Here we report a patient with a fingertip gangrene who were successfully treated with in situ bypass from the brachial artery below the elbow to the radial artery in the anatomical snuffbox under local anesthesia. Bypass graft patency was maintained during the 18-month follow-up. If the forearm cephalic vein and radial artery in the anatomical snuffbox are of adequate quality, in situ bypass to radial artery in the anatomical snuffbox may be a useful option for limb salvage in selected patients.
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