First, we simulated a vascular injury by occluding the digital arteries
at the base of each digit.
Raynaud's phenomenon is triggered by stimuli, such as cold and stress, leading to an imbalance between the constriction and expansion of the small digital arteries
. This leads to the appearance of pain, stiffness, numbness, a sensation of cold, and ulceration, with a consequent alteration in the quality of life of patients.
Initially, the bilateral digital arteries
, nerves, and two veins were exposed in the amputated part.
Shibata, "Evaluation of vascular wall elasticity of human digital arteries
using alternating current-signal photoplethysmography," Vascular Health and Risk Management, vol.
The veins and arteries at the donor site were anastomosed to the dorsal veins and digital arteries
with 10-0 suture (Figure 6).
The least common locations of these aneurysms are the palmar and digital arteries
. The etiologies of these entities are quite varied, although they usually present as a pulsatile mass.
The common palmar digital artery supplying the contiguous side of index and middle fingers passed through the neural loop formed by the proper digital nerve supplying the radial side of the middle finger and joined with the unusually large first palmar metacarpal artery before dividing into proper digital arteries
. The first palmar metacarpal artery also gave origin to radialis indicis artery which in turn ran deep to tendons of the index finger to reach index finger.
Patients typically present with blanching of the fingers or toes in which the digits appear white, which is attributed to vasospasm of the digital arteries
and resultant ischemia.
Also reported that the palmar pattern ended as the 1st, 2nd, 1st and common digital arteries
[65%] or joined the superficial palmar arch.
Normally the median artery retrogresses and the superficial palmar arch is contributed by ulnar artery but in the present case median artery persisted and it gave off two common palmar digital arteries
for lateral two and half fingers.
A trial of intraoperative clamping of the aneurysm proximally and distally resulted in decreased Doppler signals in digital arteries
. Therefore, the aneurysm was resected and an end-to-end anastomsis was done (Fig.