Open AccessPeripheral Sympathectomy for Raynaud's Phenomenon: A Salvage Procedure
Author(s) -
Wang WenHer,
Lai ChungSheng,
Chang KaoPing,
Lee SuShin,
Yang ChihChiang,
Lin SinDaw,
Liu ChiaMing
Publication year - 2006
Publication title -
the kaohsiung journal of medical sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.439
H-Index - 36
eISSN - 2410-8650
pISSN - 1607-551X
DOI - 10.1016/s1607-551x(09)70343-2
Subject(s) - medicine , sympathectomy , amputation , gangrene , peripheral , surgery , ischemia , numerical digit , angiography , perfusion , radiology , cardiology , arithmetic , mathematics
We retrospectively reviewed the effectiveness of peripheral sympathectomy for severe Raynaud's phenomenon. In this study, a total of 14 digits from six patients with chronic digital ischemic change were included. All patients had pain, ulcer, or gangrenous change in the affected digits and were unresponsive to pharmacologic or other nonsurgical therapies. In all cases, angiography showed multifocal arterial lesions, so microvascular reconstruction was unfeasible. Peripheral sympathectomy was performed as a salvage procedure to prevent digit amputation. The results were analyzed according to reduction of pain, healing of ulcers, and prevention of amputation. In 12 of the 14 digits, the ulcers healed and amputation was avoided. In the other two digits, the ulcers improved and progressive gangrene was limited. As a salvage procedure for Raynaud's phenomenon recalcitrant to conservative treatment, peripheral sympathectomy improves perfusion to ischemic digits and enables amputation to be avoided.