Palmar bypass for digital ischemia.

Although vein bypass grafting in lower extremity and heart tissue ischemia is well documented, little information exists with regard to its selective use for digital ischemia in the hand. Resection and ligation and interposition grafting are most commonly performed to treat digital ischemia and have received the most attention in the literature. We report on 3 cases of successful vein bypass grafting from the distal forearm to the palmar arch or common digital artery as a technique to reverse current and prevent further digital tip ischemia or necrosis.