Because the vessels of the hand are small and very responsive to stimu
li, arteriography of the hand requires painstaking technique, temperat
ure control, and sometimes vasodilator administration to produce suffi
cient radiographic detail, Twenty-five patients underwent arteriograph
y of the hand, which was performed from a transfemoral approach to eva
luate pathologic changes and the possibility of interventional treatme
nt, Production of high-quality images by means of attention to technic
al factors particular to the hand permitted recognition of radiographi
c detail essential to diagnosis, Twelve patients had a history of trau
ma, and five patients had congenital lesions, In eight patients, ather
osclerotic, vasospastic, or embolic arterio-occlusive disease was diag
nosed, Interventional radiologic procedures such as thrombolysis, ther
apeutic embolization, and percutaneous transluminal angioplasty are im
portant adjuvant or primary management options, Angiography of vascula
r hand lesions can yield high-quality diagnostic images when technical
factors and physiologic variables are maximized, Differentiation betw
een traumatic, congenital, and occlusive lesions is then possible.