Abstract
Ulnar artery thrombosis (UAT) is an uncommon cause of digital ischemia which occurs in less than 3% of population presenting with hand ischemia. The superficial palmar arch of which the ulnar artery is the main contributor can develop intimal damage following repetitive trauma. We present a uncommon case of a 60-year-old male farmer who presented with features of digital ischemia of right hand and found to have long segment UAT on color Doppler imaging and was managed in a step wise manner with a trial of conservative management initially followed by embolectomy, thrombectomy, and interposition vein graft as the last option. This case report brings out the rarity of UAT manifesting as digital ischemia in patient with complete SPA and the challenges faced by a surgeon in retrieving thrombi from distal segmental arteries of SPA. It also highlights the predisposing factors like occupation, presentation, and length of thrombosed segment that are crucial in determining the primary modality of treatment which was resection of thrombosed segment and RIVG in our case.
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