PERIPHERAL aneurysms are common and suggestions influencing their treatment antedate John Hunter. Arteriosclerotic aneurysms in the hand, in contrast, are rare and scant attention has been given to their treatment. In the main, treatment of these abnormalities has been dominated by Hunter's philosophy of proximal ligation or extirpation or both. Modern techniques have included preliminary or concomitant cervicodorsal sympathectomy with such extirpation.1
Because collateral circulation of the hand is so extensive, little concern has existed regarding the possibility of inflow deprivation following main trunk ligation and aneurysm excision. Clinical experience has shown that ulnar or radial artery ligation in the nonatherosclerotic hand produces no discernible circulatory deficit. However, recent experience with two cases of arteriosclerotic hand aneurysms has raised the question of adequate collateral circulation in association with these lesions. Preliminary testing in these two patients showed inadequacy of auxilliary circulation and angiography demonstrated abnormal blood flow patterns. Both
THORRENS S, TRIPPEL OH, BERGAN JJ. Arteriosclerotic Aneurysms of the HandExcision and Restoration of Continuity. Arch Surg. 1966;92(6):937–939. doi:10.1001/archsurg.1966.01320240125026
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