A 27-year-old man is found outdoors on a jogging path in the winter by a snow removal crew. Angiograms are taken of the patient’s bilateral upper extremities.
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This upper-extremity angiogram demonstrates occluded blood flow to the digits as a result of severe frostbite. Several mechanisms are involved in frostbite injury including vasoconstriction, ice crystal formation, and inflammatory responses causing thrombosis, tissue ischemia, and endothelial injury. Reperfusion injury may occur when blood flow is restored.