Case presentation: We present the case of a 42-year-old woman who is presented for evaluation with the distal phalanges of the fingers II-IV necrosis in both the upper limbs and the lower limbs.
At the time of admission, the stable hemodynamic patient without subjective accusations ECG RS with AV=110 bpm wave R amputated in V1-V5 without alteration of the repolarization phase Transthoracic echocardiography is performed which identify mild hypokinesia at the interventricular septum but with preserved global systolic function of the left ventricle. Without significant haemodynamic valvulopathy. Up-per and lower arterial arterial eco Doppler The arteries are normal caliber, their lumen is free, and the Doppler signal is normal, triphasic to distal. A coronarography is performed that highlights bicoronary lessions
Due to the presence of bicoronary lesions, cardiac surgery is required. The team of cardiologist, cardio-logist, cardiac surgeon, anesthetist and rheumatologist decide that the risk of a large surgical intervention ex-ceed the benefit of that patient with ulceronecrotic vas-culitis.
The amputation of distal phalanges of the affected fingers is performed, and later angioplasty is perfor-med with the implantation of two stents with very good end result.