Evaluating Arterialized Vein in Thumb Replantation using Indocyanine Green Angiography: A Case Report

Objective: Unusual clinical course Background: The absence of valid vessels for the anastomosis constitutes a contraindication to replantation, but the need for arterial vessels in good condition has recently been questioned and some authors have proposed the arte-rialization of the veins with promising results. However, this method is not routine in replantation and it is un-clear what conditions can establish venous congestion and loss of the replanted segment. Case Report: We detail a case where indocyanine green aids in evaluating arterialization of a vein during thumb replantation in a 40-year-old smoker following a crush injury. Multiple attempts to anastomose the princeps pollicis and its collateral vessel failed due to a thrombus formation, leaving the finger non-perfused despite urokinase treatment. To confirm the absence of reperfusion, we administered 0.3 mg/kg of indocyanine green through an upper limb peripheral vein. Observing no reperfusion, we located a suitable radial ...