000			02211nam a22003257a 4500
008			180118s20172017 xxu||||| |||| 00| 0 eng d
022			_a0974-3227
024			_a10.1055/s-0036-1597551 [doi]
024			_a1600056 [pii]
024			_aPMC5741411 [pmc]
040			_aOvid MEDLINE(R)
099			_a29302141
245			_aUse of an Intra-Arterial Catheter as a Provisional Conduit for Regulated Outflow Management in the Setting of Artery-Only Digital Replantation.
251			_aJournal of Hand and Microsurgery. 9(3):163-166, 2017 Dec
252			_aJ. hand microsurg.. 9(3):163-166, 2017 Dec
253			_aJournal of hand and microsurgery
260			_c2017
260			_fFY2018
266			_d2018-01-18
520			_aSuccessful replantation of distal digital segments necessitates the establishment of sufficient outflow to minimize congestion and progressive tissue necrosis. In cases where only arterial anastomosis is feasible, an artificial outlet must be provided to maintain physiological requirements until microvenous circulation regenerates. This can be accomplished using any number of "exsanguination techniques" designed to facilitate egress through ongoing passive blood loss. Although reportedly effective, these measures are imprecise and carry a substantial risk of infection, scarring, and/or uncontrolled hemorrhage. Herein, we describe a preemptive alternative for provisional venous drainage, whereby direct catheterization of a distal arterial branch is used to enhance the precision of outflow management following artery-only digital replantation. The establishment of intravascular access, using the technique described, permits remote manipulation of the microcirculatory environment through timed administration of heparinized saline and regulated removal of controlled volumes of blood.
546			_aEnglish
650			_aPubMed-not-MEDLINE -- Not indexed
656			_aCurtis National Hand Center
657			_aJournal Article
700			_aHan, Kevin D
700			_aParyavi, Ebrahim
790			_aDeFazio MV, Han KD, Paryavi E
856			_uhttps://dx.doi.org/10.1055/s-0036-1597551 _zhttps://dx.doi.org/10.1055/s-0036-1597551
942			_cART _dArticle
999			_c2986 _d2986