Vascular Conditions of the Hand

Abstract

Treating vascular conditions of the hand requires a thorough understanding of the vascular anatomy of the hand and upper extremity. Treatment options include both operative and nonoperative modalities, and may involve a multidisciplinary team including vascular surgeons, hand surgeons, interventional radiologists, medical internists, and hand therapists. This review discusses the vascular anatomy, patient evaluation, and treatment of vascular conditions of the hand. Figures show the large blood vessels of the arm, locations of the bifurcation of the radial and ulnar arteries, the vascular branches of the arm, the vascular anatomy of the hand and wrist, the location of the superficial palmar arch, upper extremity angiography, the clinical appearance and venograms of phlegmasia cerulean dolens, a high-flow arteriovenous malformation involving the right long finger, images of a patient who experienced blunt trauma to his distal palm from a wood splinter, a 28-year-old male who developed forearm compartment syndrome, volar and dorsal appearance of the left hand of a 56-year-old male with Raynaud phenomenon secondary to scleroderma, and intraoperative images of a patient who underwent digital palmar sympathectomies. A video shows a periarterial digital sympathectomy. Tables list the distinction between Raynaud disease and Raynaud phenomenon, comparison of investigational modalities of vascular conditions, interpretation of segmental arterial pressures, Wake Forest classification of vasospastic and vaso-occlusive disease, and Jones classification of vein bypass graft configurations in upper extremity vascular reconstruction. This review contains 12 figures, 1 video, 5 tables, and 66 references.