Journal of the American College of Surgeons
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Hand ischemia is a rare but potentially devastating complication of radial artery cannulation for arterial monitoring. The causes and ultimate outcomes of hand ischemia after radial artery cannulation are unclear. ⋯ These data show that hand ischemia after radial artery cannulation is associated with high risk of tissue loss or amputation. Operative repair offered no advantage over nonoperative therapy in prevention of digital gangrene in this series. We hypothesize that digital gangrene results from distal embolization from the site of the initial arterial thrombosis, producing ischemia that is not remediated by radial artery revascularization. Nonoperative therapy with vasodilators can be equally effective in treating cannula-induced radial artery injuries in some patients.