title: Acute palmer digital artery occlusion treated using endoscopic ablation of the thoracic sympathetic.
abstract: Acute occlusion of the digital arteries frequently causes painful infarction requiring digital amputation. We describe a 55-year-old male patient who presented with acute onset of digital ischemia with impending gangrene on the right hand. Because angiography revealed bypass surgery was not feasible, he underwent thoracoscopic sympathectomy (TS) one week after onset of the symptom, which resulted in rapid pain resolution. He was diagnosed, thereafter, with malignant rheumatoid arthritis and methotrexate was administered. Postoperative angiography revealed that the occluded digital artery had become recanalized. Timely TS is therefore a treatment of choice for acute digital ischemia.
authors.affiliation: Department of Vascular Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
authors.forename: Chiaki
authors.initials: C
authors.lastname: Kamiya
authors.forename: Tadashi
authors.initials: T
authors.lastname: Kitaoka
authors.forename: Kota
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Harunobu
authors.initials: H
authors.lastname: Matsumoto
authors.forename: Juno
authors.initials: J
authors.lastname: Deguchi
authors.forename: Osamu
authors.initials: O
authors.lastname: Sato
keywords: digital arterial occlusion; gangrene; rheumatoid arthritis; thoracoscopic sympathectomy
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