title: Peripheral sympathectomy for Raynaud's phenomenon: a salvage procedure.
abstract: 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.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Wen-Her
authors.initials: WH
authors.lastname: Wang
authors.forename: Chung-Sheng
authors.initials: CS
authors.lastname: Lai
authors.forename: Kao-Ping
authors.initials: KP
authors.lastname: Chang
authors.forename: Su-Shin
authors.initials: SS
authors.lastname: Lee
authors.forename: Chih-Chiang
authors.initials: CC
authors.lastname: Yang
authors.forename: Sin-Daw
authors.initials: SD
authors.lastname: Lin
authors.forename: Chia-Ming
authors.initials: CM
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011928:Raynaud Disease / Q000601:surgery*; D012189:Retrospective Studies; D016879:Salvage Therapy; D013562:Sympathectomy / Q000379:methods*