03:00 PM Abstract No. 63 Below-the-elbow revascularization for the treatment of upper extremity critical limb ischemia

Abstract

To report the results of below-the-elbow (BTE) arterial revascularization in patients with critical hand ischemia (CHI) and End Stage Renal Disease (ESRD). We retrospectively identified all patients with critical limb ischemia treated with below-the-elbow arterial angioplasty and/or atherectomy between 2013 and 2017. Patient demographics, co-morbidities, and procedural data were reviewed. Rates of hand salvage, technical and clinical success were evaluated. Mean age at treatment was 59.7 (50-72). Average time to follow up was 9 months (2-26 months). 7 ESRD patients (3 female) with a total of 9 hands affected by BTE arterial occlusion and CHI were treated. The technical success rate was 88.9% (8/9). No major or minor complications occurred. 6 hands (66.6%) suffered from non-healing ulcers and gangrene; the remaining 3 (33.3%) presented with rest pain. 1 patient died in the first 30 days of follow up due to pre-existing respiratory disease. The mean treated lesion length was 147.5±97.9 mm. Among the successfully treated patients, the hand salvage rate was 87.5% (7/8). One patient did however undergo planned digital amputation following intervention with satisfactory healing of the postoperative stump. Arterial revascularization of the BTE arteries for CHI was a safe and a technically feasible method to improve the hand salvage rate in ESRD patients.