Arterialization of the Venous System for Treatment of Chronic Ischemia in the Hand

Symptomatic chronic ischemia of the upper extremity is a difficult condition to treat. At a critical level of ischemia, patients suffer from intractable pain and nonhealing ulcerations and potentially necrosis. When no distal vessels are available for vascular reconstruction, arterialization of the venous system is a salvage procedure that may be considered. This article describes a surgical technique for venous arterialization to improve the vascular supply to the ischemic hand, which can result in decreased pain, wound healing, improved patient function, and limb salvage.