A sixty years old Yemani man presented to the Vascular surgery department in the Saudi German hospital Jeddah, suffering of gangrene of three fingers of his left hand. Investigations proved that he has obstruction of the arteries of the forearm and obstruction of the arteries of the hand. So he had three different types of surgery to save his left hand.

 

The first operation was by (endovascular surgery) using arterial catheter to dilate the obstruction by a balloon and put a stent to keep the obstruction opened.

Next day the second operation was done by (Thoracoscopic surgery) doing excesion of a specific segment of the sympathetic chain of the thorax to dilate the small arteries of the hand which was done through the endoscope.

The Third type of Surgery which was done for the patient was (open surgery),

which was done at the end to excise the gangrenous parts of the fingers of the left hand. The three different operations was done in three successive days, all of these operations was done by Dr. Mahmoud Salah, Consultant and head of ascular and endovascular surgery department in the Saudi German hospital Jeddah. Patient improved much and his hand was saved. Thanks God.