<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT02228057</url>
  </required_header>
  <id_info>
    <org_study_id>PRO12010024</org_study_id>
    <nct_id>NCT02228057</nct_id>
  </id_info>
  <brief_title>Long Term Patency Following Arterial Repair</brief_title>
  <official_title>Long Term Patency Following Arterial Repair</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>University of Pittsburgh</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>University of Pittsburgh</source>
  <oversight_info>
    <has_dmc>No</has_dmc>
  </oversight_info>
  <brief_summary>
    <textblock>
      Injury to the blood vessels of the extremities, and more specifically the arteries, can&#xD;
      result from fractures and severe crush injuries. It occurs in about 3% of the general&#xD;
      population. People affected by blood vessel injuries can have important problems, including&#xD;
      cold intolerance, general pain, and weakened function of the associated limb. Even after&#xD;
      surgical intervention to repair the affected artery, people may still experience numbness,&#xD;
      problems with movement, and an inadequate supply of oxygen to the limb. These symptoms are&#xD;
      particularly relevant in the case of forearm arterial repairs because this repair directly&#xD;
      affects one of our most vital structures: the hand. Despite available interventions and&#xD;
      advances in microsurgical technique, arterial repairs can still result in significant sensory&#xD;
      and functional impairment of the hand. Once an artery within the arm is injured, a surgeon's&#xD;
      primary goal is to restore blood flow to the hand and prevent functional impairment. Even&#xD;
      with a prompt effort to restore hand perfusion, long-term (greater than 6 months) sensory and&#xD;
      motor function is hard to predict.&#xD;
&#xD;
      Furthermore, sometimes the repaired artery becomes occluded over time. We believe that this&#xD;
      occlusion has a direct impact on a patient's perceived pain and cold intolerance at the level&#xD;
      of the hand.&#xD;
&#xD;
      In this study, we are investigating the occurrence of blood vessel occlusion in the arm after&#xD;
      at least 6 months of surgery and the impact of this event. To assess this we will use&#xD;
      physical exams, non-invasive tests, duplex doppler ultrasound and questionnaires.&#xD;
      Questionnaires, including the DASH (disabilities of the arm, shoulder,and hand), CISS (Cold&#xD;
      Intolerance Symptom Severity Questionnaire), and Michigan hand score, will be used to assess&#xD;
      pain, sensory, and motor impairments in both the affected and unaffected hand. Functional&#xD;
      assessments will include 2-point discrimination, grip strength, pinch strength, capillary&#xD;
      refill and range of motion.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      Vascular injuries of the extremities can result from fractures, severe crush injuries,&#xD;
      lacerations, and even iatrogenic causes, such as surgical interventions. Its prevalence is&#xD;
      about 3% in the general population with increased incidence during times of war. Patients&#xD;
      affected by vascular injuries can have significant morbidities, including cold intolerance,&#xD;
      pain, sensory abnormalities, and weakness of the affected limb. Even after repair of the&#xD;
      affected artery, patients may still experience paresthesias, motor function abnormalities and&#xD;
      pain and cold intolerance. These symptoms are particularly relevant in the case of arm&#xD;
      arterial repairs because this repair directly affects the function of the hand. Different&#xD;
      techniques of arterial repair have evolved over time. Venous grafts (i.e. saphenous and&#xD;
      dorsal hand veins) can be employed to repair the damaged vessel. Although most appropriate&#xD;
      for treating long gaps, vein grafts have several disadvantages. There is often a diameter&#xD;
      mismatch between the harvested vein and the damaged artery which can compromise the repair&#xD;
      site. Furthermore, veins are more compliant and have higher volume storage capabilities than&#xD;
      their arterial counterparts. These inherent venous qualities can alter blood flow to the limb&#xD;
      causing stasis, turbulence, and eventually, stenosis of the graft. Other methodologies have&#xD;
      been developed in an effort to balance the negatives associated with venous grafting,&#xD;
      including synthetic graft use, arterial ligation, end-to-side anastomosis, and end-to-end&#xD;
      repair. Despite available interventions and advances in microsurgical technique, arterial&#xD;
      repair in the arm, can still result in significant functional impairment of the upper&#xD;
      extremity. The hand is highly perfused with a dual arterial system that arches across the&#xD;
      dorsal and palmar surface of the hand. Once an upper extremity artery is compromised, a&#xD;
      surgeon's primary goal is to restore blood flow to the hand so as to prevent impairment.&#xD;
      Despite a surgeon's best efforts, long term (greater than 6 months) outcomes are hard to&#xD;
      predict. Furthermore, the patency rates of the arterial repair have been consistently&#xD;
      reported at approximately 50%. We believe that the long term patency of the upper extremity&#xD;
      artery has a direct effect on a patient's perceived pain and cold intolerance, sensibility,&#xD;
      and motor function of the hand. Our hypothesis is that repaired arteries in the upper&#xD;
      extremity will have an occlusion rate of 50% in the long term (greater than 6 months&#xD;
      post-surgery) and that this occlusion is responsible for motor and sensory function&#xD;
      abnormalities, pain, and cold-intolerance. We will use high resolution duplex Doppler&#xD;
      ultrasound to investigate occlusion rates of repaired arteries and compare those to the&#xD;
      unaffected contralateral arteries (internal control). Questionnaires, including the DASH&#xD;
      (disabilities of the arm, shoulder, and hand), CISS (Cold Intolerance Symptom Severity&#xD;
      Questionnaire), and Michigan hand score, will be used to assess pain, cold intolerance,&#xD;
      sensory, and motor impairments in both the affected and unaffected hand. Functional&#xD;
      assessments will include 2-point discrimination, grip strength, pinch strength, capillary&#xD;
      refill and range of motion.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Completed</overall_status>
  <start_date>August 2014</start_date>
  <completion_date type="Actual">February 2015</completion_date>
  <primary_completion_date type="Actual">February 2015</primary_completion_date>
  <study_type>Observational</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <observational_model>Cohort</observational_model>
    <time_perspective>Prospective</time_perspective>
  </study_design_info>
  <primary_outcome>
    <measure>relationship of time after arterial repair with patency of the vessel</measure>
    <time_frame>at least 6 months after surgery</time_frame>
    <description>By using ultrasound, both the ulnar and radial artery will be visualized in both arms and using color ultrasound, we will detect the bloodflow. If no flow is present we will assume that the vessel is occluded.</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Correlation between arterial patency and cold intolerance.</measure>
    <time_frame>at least 6 months after surgery</time_frame>
    <description>Both hands will be assessed for cold intolerance. To assess this we will use the CISS questionnaire (Cold Intolerance Symptom Severity Questionnaire).</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Correlation between arterial patency and digital sensibility.</measure>
    <time_frame>at least 6 months after surgery</time_frame>
    <description>Both hands will be assessed for sensibility. To assess this we will use physical exams and questionnaires. Questionnaires, including the DASH (disabilities of the arm, shoulder,and hand) and Michigan hand score will be used to assess sensibility in both the affected and unaffected hand. A functional assessment for sensibility will be the 2-point discrimination.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Correlation between arterial patency and hand strength.</measure>
    <time_frame>at least 6 months after surgery</time_frame>
    <description>Functional assessments will include grip strength and pinch strength.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Correlation between arterial patency and capillary refill</measure>
    <time_frame>at least 6 months after surgery</time_frame>
    <description>Vascular assessment will include capillary refill.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Correlation between arterial patency and range of movement of the fingers</measure>
    <time_frame>at least 6 months after surgery</time_frame>
    <description>Functional assessments will include the measurement of the distance of the fingertips to the distal palmar crease when the fingers are maximally flexed.</description>
  </secondary_outcome>
  <number_of_groups>1</number_of_groups>
  <enrollment type="Actual">13</enrollment>
  <condition>Upper Extremity Arterial Surgery</condition>
  <arm_group>
    <arm_group_label>operated group</arm_group_label>
    <description>all patients who had upper extremity artery surgery at least 6 months ago</description>
  </arm_group>
  <eligibility>
    <study_pop>
      <textblock>
        patients that underwent upper extremity arterial surgery and are at least 6 months out of&#xD;
        surgery.&#xD;
      </textblock>
    </study_pop>
    <sampling_method>Non-Probability Sample</sampling_method>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
        Patients meeting the following criteria will be eligible to participate in this study:&#xD;
&#xD;
          1. Age 18 and over&#xD;
&#xD;
          2. Able to provide informed consent&#xD;
&#xD;
          3. Have previously underwent surgery for an arm arterial repair&#xD;
&#xD;
          4. Be at least 6 months post-arterial repair&#xD;
&#xD;
          5. Willing and able to comply with follow-up tests/procedures and questionnaires&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
        Patients meeting the following criteria will be excluded from this study:&#xD;
&#xD;
          1. Age less than 18 years&#xD;
&#xD;
          2. Unable to provide informed consent&#xD;
&#xD;
          3. Nerve repair in extremity of interest&#xD;
&#xD;
          4. Any condition which compromises the contralateral hand to serve as a reliable internal&#xD;
             control&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>18 Years</minimum_age>
    <maximum_age>N/A</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Alexander M. Spiess, MD</last_name>
    <role>Principal Investigator</role>
    <affiliation>University of Pittsburgh</affiliation>
  </overall_official>
  <location>
    <facility>
      <name>University of Pittsburgh Scaife Hall</name>
      <address>
        <city>Pittsburgh</city>
        <state>Pennsylvania</state>
        <zip>15261</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location_countries>
    <country>United States</country>
  </location_countries>
  <reference>
    <citation>Knobloch K, Vogt PM. On &quot;patency of radial arteries reconstructed after radial forearm flap harvest (J Reconstr Microsurg 2007;23:347-350)&quot;. J Reconstr Microsurg. 2009 Jan;25(1):77-8; author reply 79-80. doi: 10.1055/s-0028-1090602. Epub 2008 Oct 16. No abstract available.</citation>
    <PMID>18925541</PMID>
  </reference>
  <reference>
    <citation>Gelberman RH, Nunley JA, Koman LA, Gould JS, Hergenroeder PT, MacClean CR, Urbaniak JR. The results of radial and ulnar arterial repair in the forearm. Experience in three medical centers. J Bone Joint Surg Am. 1982 Mar;64(3):383-7.</citation>
    <PMID>7061556</PMID>
  </reference>
  <reference>
    <citation>Nunley JA, Goldner RD, Koman LA, Gelberman R, Urbaniak JR. Arterial stump pressure: a determinant of arterial patency? J Hand Surg Am. 1987 Mar;12(2):245-9. doi: 10.1016/s0363-5023(87)80280-0.</citation>
    <PMID>3559079</PMID>
  </reference>
  <reference>
    <citation>Lee RE, Obeid FN, Horst HM, Bivins BA. Acute penetrating arterial injuries of the forearm. Ligation or repair? Am Surg. 1985 Jun;51(6):318-24.</citation>
    <PMID>3994174</PMID>
  </reference>
  <reference>
    <citation>Deutinger M, Porenta G, Metz V, Kaliman J, Freilinger G. [Hemodynamic and clinical studies following injury of the arteries of the forearm]. Handchir Mikrochir Plast Chir. 1989 Nov;21(6):283-6. German.</citation>
    <PMID>2606367</PMID>
  </reference>
  <reference>
    <citation>Aftabuddin M, Islam N, Jafar MA, Haque E, Alimuzzaman M. Management of isolated radial or ulnar arteries at the forearm. J Trauma. 1995 Jan;38(1):149-51. doi: 10.1097/00005373-199501000-00033.</citation>
    <PMID>7745646</PMID>
  </reference>
  <reference>
    <citation>Daoutis N, Gerostathopoulos N, Bouchlis G, Efstathopoulos D, Misitzis D, Anagnostou S, Vasiliadiw A. Results after repair of traumatic arterial damage in the forearm. Microsurgery. 1992;13(4):175-7. doi: 10.1002/micr.1920130405.</citation>
    <PMID>1495376</PMID>
  </reference>
  <reference>
    <citation>Johnson M, Ford M, Johansen K. Radial or ulnar artery laceration. Repair or ligate? Arch Surg. 1993 Sep;128(9):971-4; discussion 974-5. doi: 10.1001/archsurg.1993.01420210031004.</citation>
    <PMID>8368933</PMID>
  </reference>
  <reference>
    <citation>Ge XZ, Huang GK. Use of distal arteries for microvascular reconstruction in forearm and hand surgery. Microsurgery. 1996;17(4):180-3. doi: 10.1002/(SICI)1098-2752(1996)17:43.0.CO;2-P.</citation>
    <PMID>9140949</PMID>
  </reference>
  <reference>
    <citation>Hentschel M, Rucker G. [Treatment of arterial injuries of the forearm and hand]. Handchirurgie. 1970;2(1):18-21. No abstract available. German.</citation>
    <PMID>5538419</PMID>
  </reference>
  <reference>
    <citation>Stricker SJ, Burkhalter WE, Ouellette AE. Single-vessel forearm arterial repairs. Patency rates using nuclear angiography. Orthopedics. 1989 Jul;12(7):963-5. doi: 10.3928/0147-7447-19890701-08.</citation>
    <PMID>2771822</PMID>
  </reference>
  <reference>
    <citation>Gelberman RH, Blasingame JP, Fronek A, Dimick MP. Forearm arterial injuries. J Hand Surg Am. 1979 Sep;4(5):401-8. doi: 10.1016/s0363-5023(79)80031-3.</citation>
    <PMID>501048</PMID>
  </reference>
  <reference>
    <citation>Rothkopf DM, Chu B, Gonzalez F, Borah G, Ashmead D 4th, Dunn R. Radial and ulnar artery repairs: assessing patency rates with color Doppler ultrasonographic imaging. J Hand Surg Am. 1993 Jul;18(4):626-8. doi: 10.1016/0363-5023(93)90305-M.</citation>
    <PMID>8349969</PMID>
  </reference>
  <verification_date>February 2015</verification_date>
  <study_first_submitted>August 25, 2014</study_first_submitted>
  <study_first_submitted_qc>August 27, 2014</study_first_submitted_qc>
  <study_first_posted type="Estimate">August 28, 2014</study_first_posted>
  <last_update_submitted>February 11, 2015</last_update_submitted>
  <last_update_submitted_qc>February 11, 2015</last_update_submitted_qc>
  <last_update_posted type="Estimate">February 13, 2015</last_update_posted>
  <responsible_party>
    <responsible_party_type>Principal Investigator</responsible_party_type>
    <investigator_affiliation>University of Pittsburgh</investigator_affiliation>
    <investigator_full_name>Alexander M Spiess, MD</investigator_full_name>
    <investigator_title>Dr.</investigator_title>
  </responsible_party>
  <keyword>arterial patency</keyword>
  <keyword>upper extremity</keyword>
  <keyword>anastomosis</keyword>
  <keyword>sensibility</keyword>
  <keyword>pain</keyword>
  <keyword>cold intolerance</keyword>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT02228057
org study id: PRO12010024
nct id: NCT02228057
lead sponsor: 
has dmc: No
Injury to the blood vessels of the extremities, and more specifically the arteries, can
      result from fractures and severe crush injuries. It occurs in about 3% of the general
      population. People affected by blood vessel injuries can have important problems, including
      cold intolerance, general pain, and weakened function of the associated limb. Even after
      surgical intervention to repair the affected artery, people may still experience numbness,
      problems with movement, and an inadequate supply of oxygen to the limb. These symptoms are
      particularly relevant in the case of forearm arterial repairs because this repair directly
      affects one of our most vital structures: the hand. Despite available interventions and
      advances in microsurgical technique, arterial repairs can still result in significant sensory
      and functional impairment of the hand. Once an artery within the arm is injured, a surgeon's
      primary goal is to restore blood flow to the hand and prevent functional impairment. Even
      with a prompt effort to restore hand perfusion, long-term (greater than 6 months) sensory and
      motor function is hard to predict.

      Furthermore, sometimes the repaired artery becomes occluded over time. We believe that this
      occlusion has a direct impact on a patient's perceived pain and cold intolerance at the level
      of the hand.

      In this study, we are investigating the occurrence of blood vessel occlusion in the arm after
      at least 6 months of surgery and the impact of this event. To assess this we will use
      physical exams, non-invasive tests, duplex doppler ultrasound and questionnaires.
      Questionnaires, including the DASH (disabilities of the arm, shoulder,and hand), CISS (Cold
      Intolerance Symptom Severity Questionnaire), and Michigan hand score, will be used to assess
      pain, sensory, and motor impairments in both the affected and unaffected hand. Functional
      assessments will include 2-point discrimination, grip strength, pinch strength, capillary
      refill and range of motion.
Vascular injuries of the extremities can result from fractures, severe crush injuries,
      lacerations, and even iatrogenic causes, such as surgical interventions. Its prevalence is
      about 3% in the general population with increased incidence during times of war. Patients
      affected by vascular injuries can have significant morbidities, including cold intolerance,
      pain, sensory abnormalities, and weakness of the affected limb. Even after repair of the
      affected artery, patients may still experience paresthesias, motor function abnormalities and
      pain and cold intolerance. These symptoms are particularly relevant in the case of arm
      arterial repairs because this repair directly affects the function of the hand. Different
      techniques of arterial repair have evolved over time. Venous grafts (i.e. saphenous and
      dorsal hand veins) can be employed to repair the damaged vessel. Although most appropriate
      for treating long gaps, vein grafts have several disadvantages. There is often a diameter
      mismatch between the harvested vein and the damaged artery which can compromise the repair
      site. Furthermore, veins are more compliant and have higher volume storage capabilities than
      their arterial counterparts. These inherent venous qualities can alter blood flow to the limb
      causing stasis, turbulence, and eventually, stenosis of the graft. Other methodologies have
      been developed in an effort to balance the negatives associated with venous grafting,
      including synthetic graft use, arterial ligation, end-to-side anastomosis, and end-to-end
      repair. Despite available interventions and advances in microsurgical technique, arterial
      repair in the arm, can still result in significant functional impairment of the upper
      extremity. The hand is highly perfused with a dual arterial system that arches across the
      dorsal and palmar surface of the hand. Once an upper extremity artery is compromised, a
      surgeon's primary goal is to restore blood flow to the hand so as to prevent impairment.
      Despite a surgeon's best efforts, long term (greater than 6 months) outcomes are hard to
      predict. Furthermore, the patency rates of the arterial repair have been consistently
      reported at approximately 50%. We believe that the long term patency of the upper extremity
      artery has a direct effect on a patient's perceived pain and cold intolerance, sensibility,
      and motor function of the hand. Our hypothesis is that repaired arteries in the upper
      extremity will have an occlusion rate of 50% in the long term (greater than 6 months
      post-surgery) and that this occlusion is responsible for motor and sensory function
      abnormalities, pain, and cold-intolerance. We will use high resolution duplex Doppler
      ultrasound to investigate occlusion rates of repaired arteries and compare those to the
      unaffected contralateral arteries (internal control). Questionnaires, including the DASH
      (disabilities of the arm, shoulder, and hand), CISS (Cold Intolerance Symptom Severity
      Questionnaire), and Michigan hand score, will be used to assess pain, cold intolerance,
      sensory, and motor impairments in both the affected and unaffected hand. Functional
      assessments will include 2-point discrimination, grip strength, pinch strength, capillary
      refill and range of motion.
observational model: Cohort
time perspective: Prospective
measure: relationship of time after arterial repair with patency of the vessel
time frame: at least 6 months after surgery
description: By using ultrasound, both the ulnar and radial artery will be visualized in both arms and using color ultrasound, we will detect the bloodflow. If no flow is present we will assume that the vessel is occluded.
measure: Correlation between arterial patency and cold intolerance.
time frame: at least 6 months after surgery
description: Both hands will be assessed for cold intolerance. To assess this we will use the CISS questionnaire (Cold Intolerance Symptom Severity Questionnaire).
measure: Correlation between arterial patency and digital sensibility.
time frame: at least 6 months after surgery
description: Both hands will be assessed for sensibility. To assess this we will use physical exams and questionnaires. Questionnaires, including the DASH (disabilities of the arm, shoulder,and hand) and Michigan hand score will be used to assess sensibility in both the affected and unaffected hand. A functional assessment for sensibility will be the 2-point discrimination.
measure: Correlation between arterial patency and hand strength.
time frame: at least 6 months after surgery
description: Functional assessments will include grip strength and pinch strength.
measure: Correlation between arterial patency and capillary refill
time frame: at least 6 months after surgery
description: Vascular assessment will include capillary refill.
measure: Correlation between arterial patency and range of movement of the fingers
time frame: at least 6 months after surgery
description: Functional assessments will include the measurement of the distance of the fingertips to the distal palmar crease when the fingers are maximally flexed.
arm group label: operated group
description: all patients who had upper extremity artery surgery at least 6 months ago
study pop: 
sampling method: Non-Probability Sample
criteria: 
gender: All
minimum age: 18 Years
maximum age: N/A
healthy volunteers: No
last name: Alexander M. Spiess, MD
role: Principal Investigator
affiliation: University of Pittsburgh
facility: 
country: United States
citation: Knobloch K, Vogt PM. On "patency of radial arteries reconstructed after radial forearm flap harvest (J Reconstr Microsurg 2007;23:347-350)". J Reconstr Microsurg. 2009 Jan;25(1):77-8; author reply 79-80. doi: 10.1055/s-0028-1090602. Epub 2008 Oct 16. No abstract available.
PMID: 18925541
citation: Gelberman RH, Nunley JA, Koman LA, Gould JS, Hergenroeder PT, MacClean CR, Urbaniak JR. The results of radial and ulnar arterial repair in the forearm. Experience in three medical centers. J Bone Joint Surg Am. 1982 Mar;64(3):383-7.
PMID: 7061556
citation: Nunley JA, Goldner RD, Koman LA, Gelberman R, Urbaniak JR. Arterial stump pressure: a determinant of arterial patency? J Hand Surg Am. 1987 Mar;12(2):245-9. doi: 10.1016/s0363-5023(87)80280-0.
PMID: 3559079
citation: Lee RE, Obeid FN, Horst HM, Bivins BA. Acute penetrating arterial injuries of the forearm. Ligation or repair? Am Surg. 1985 Jun;51(6):318-24.
PMID: 3994174
citation: Deutinger M, Porenta G, Metz V, Kaliman J, Freilinger G. [Hemodynamic and clinical studies following injury of the arteries of the forearm]. Handchir Mikrochir Plast Chir. 1989 Nov;21(6):283-6. German.
PMID: 2606367
citation: Aftabuddin M, Islam N, Jafar MA, Haque E, Alimuzzaman M. Management of isolated radial or ulnar arteries at the forearm. J Trauma. 1995 Jan;38(1):149-51. doi: 10.1097/00005373-199501000-00033.
PMID: 7745646
citation: Daoutis N, Gerostathopoulos N, Bouchlis G, Efstathopoulos D, Misitzis D, Anagnostou S, Vasiliadiw A. Results after repair of traumatic arterial damage in the forearm. Microsurgery. 1992;13(4):175-7. doi: 10.1002/micr.1920130405.
PMID: 1495376
citation: Johnson M, Ford M, Johansen K. Radial or ulnar artery laceration. Repair or ligate? Arch Surg. 1993 Sep;128(9):971-4; discussion 974-5. doi: 10.1001/archsurg.1993.01420210031004.
PMID: 8368933
citation: Ge XZ, Huang GK. Use of distal arteries for microvascular reconstruction in forearm and hand surgery. Microsurgery. 1996;17(4):180-3. doi: 10.1002/(SICI)1098-2752(1996)17:43.0.CO;2-P.
PMID: 9140949
citation: Hentschel M, Rucker G. [Treatment of arterial injuries of the forearm and hand]. Handchirurgie. 1970;2(1):18-21. No abstract available. German.
PMID: 5538419
citation: Stricker SJ, Burkhalter WE, Ouellette AE. Single-vessel forearm arterial repairs. Patency rates using nuclear angiography. Orthopedics. 1989 Jul;12(7):963-5. doi: 10.3928/0147-7447-19890701-08.
PMID: 2771822
citation: Gelberman RH, Blasingame JP, Fronek A, Dimick MP. Forearm arterial injuries. J Hand Surg Am. 1979 Sep;4(5):401-8. doi: 10.1016/s0363-5023(79)80031-3.
PMID: 501048
citation: Rothkopf DM, Chu B, Gonzalez F, Borah G, Ashmead D 4th, Dunn R. Radial and ulnar artery repairs: assessing patency rates with color Doppler ultrasonographic imaging. J Hand Surg Am. 1993 Jul;18(4):626-8. doi: 10.1016/0363-5023(93)90305-M.
PMID: 8349969
responsible party type: Principal Investigator
investigator affiliation: University of Pittsburgh
investigator full name: Alexander M Spiess, MD
investigator title: Dr.