Microvascular salvage of the embolized hand

Obstruction of the distal vasculature in the upper extremity can produce disabling ischeic symptoms and even threaten the viability of the fingers. Advances in microsurgical technique have made digital salvage possible by several means. Preoperative arteriographic studies are recommended when any revascularization procedure is contemplated. When the obstructing lesion, either embolus or thrombosis, is found to be extensive and not amenable to a simple resection or vein grafting, revascularization based on adjacent arterial supply can be an effective alternative means of treatment.