Late arteriovenous fistula after finger replantation

Late arteriovenous fistula after finger replantation The occurrence of arteriovenous fistula (AV) after finger replantation is a very rare complication. Since the first replantation performed in the Czech Republic in 1979, there has been one such case. A four-finger replantation was done for an injury on the right dominant hand on a 29-year-old patient. After 6 months, an arteriovenous fistula developed on the fourth finger. The other fingers were not affected. Following examination by digital subtraction angiography, selective ligature of the common digital artery for the fourth interdigital space was performed. Catheterization and embolization methods were not used. After detailed analysis of the factors which may have caused this complication, the following preventative and therapeutic approach is proposed. It is necessary to avoid tissue damage caused by cold. The advisable rate should be at least 1:1 between venous drainage of the finger in the area of the basic phalanx and the arterial supplementation. It would be better, however, to have the ratio at 2:1 or more. In case of the AV fistula formation before radical intervention, selective ligation of an artery causing vascular dilatation is advantageous. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png European Journal of Plastic Surgery Springer Journals

Late arteriovenous fistula after finger replantation

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Publisher
Springer-Verlag
Copyright
Copyright © 2005 by Springer-Verlag
Subject
Medicine
ISSN
0930-343X
eISSN
1435-0130
D.O.I.
10.1007/s00238-005-0787-2
Publisher site
See Article on Publisher Site

Abstract

The occurrence of arteriovenous fistula (AV) after finger replantation is a very rare complication. Since the first replantation performed in the Czech Republic in 1979, there has been one such case. A four-finger replantation was done for an injury on the right dominant hand on a 29-year-old patient. After 6 months, an arteriovenous fistula developed on the fourth finger. The other fingers were not affected. Following examination by digital subtraction angiography, selective ligature of the common digital artery for the fourth interdigital space was performed. Catheterization and embolization methods were not used. After detailed analysis of the factors which may have caused this complication, the following preventative and therapeutic approach is proposed. It is necessary to avoid tissue damage caused by cold. The advisable rate should be at least 1:1 between venous drainage of the finger in the area of the basic phalanx and the arterial supplementation. It would be better, however, to have the ratio at 2:1 or more. In case of the AV fistula formation before radical intervention, selective ligation of an artery causing vascular dilatation is advantageous.

Journal

European Journal of Plastic SurgerySpringer Journals

Published: Jan 1, 2006

References

  • New instruments for microvascular surgery
    Acland, R
  • Identification of an arteriovenous fistula during free tissue transfer despite negative preoperative angiography: a potentially correctable cause of venous thrombosis
    Tomaino, MM; Leit, M; Plakseychuk, A

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