Radiofrequency upper thoracic sympathectomy in the treatment of critical upper limb ischemia--a case series.
BACKGROUND
Patients with significant medical and social problems resulting from impaired perfusion of the upper limbs caused by micro- or macro-angiopathy are now frequent in clinical practice. Vasospastic disease of the upper limbs of combined origin is a difficult condition to treat by conservative methods and therapeutic strategies are usually multidisciplinary. In addition to standard pharmacotherapy, treatment may involve regional anaesthesia, thoracoscopic or radiofrequency sympathectomy and surgical treatment of defects, including plastic surgery.


METHODS
This paper describes our successful work in the treatment of upper limb critical ischemia using radiofrequency upper thoracic sympathectomy.


RESULTS
In three case reports we present the results of radiofrequency thermolysis applied to treat patients with chronic defects of the hand and fingers. These patients were diagnosed with upper limb critical ischemia of combined origin, standard conservative treatment methods failed and surgical intervention was originally not indicated, however, radiofrequency thermolysis proved to be beneficial.


CONCLUSIONS
Radiofrequency thoracic sympathectomy could improve peripheral perfusion of the upper limbs and thereby contribute to healing of chronic defects, reduction of pain and improvement in the quality of life of the patients.
Department of Anaesthesiology and Intensive Care Medicine, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic. tomas.gabrhelik@fnol.cz
Tomas
T
Gabrhelik
Daniel
D
Stehlik
Milan
M
Adamus
Bohumil
B
Zalesak
Pavel
P
Michalek
D000328:Adult; D004560:Electricity; D005260:Female; D005385:Fingers / Q000098:blood supply / Q000601:surgery; D006225:Hand / Q000098:blood supply / Q000601:surgery; D006801:Humans; D007511:Ischemia / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017534:Radial Artery / Q000601:surgery; D013562:Sympathectomy / Q000379:methods*; D013564:Sympathetic Nervous System / Q000601:surgery; D016896:Treatment Outcome; D017535:Ulnar Artery / Q000601:surgery