Adventitial stripping: a digit saving procedure in refractory Raynaud's phenomenon.

摘要: Objective. To assess the efficacy and role of adventitial stripping (i.e., digital sympathectomy) in patients with severe ischemia secondary to refractory Raynaud's phenomenon (RP). Methods. A retrospective chart review 13 consecutive cases 9 RP was performed, examining patient characteristics, previous therapeutic interventions, postoperative outcomes. An illustrative case is presented. Results. All identified had evidence systemic disease. After stripping, sustained longterm improvement achieved all ischemic digits, 8 which showed amelioration symptoms immediately after surgery. In 2 patients, noted despite progressive nonoperated digits. The mean followup time 28 months (range 10 47). No complications were observed. Pre-operative sympathetic nerve blockade performed 12 cases, no clinical response. Pathologic specimens revealed fibrosis that caused extrinsic compression arteries. Conclusion. Adventitial arteries an extremely effective safe option for RP. this procedure results not only from denervation but also decompression vessel through removal a fibrotic noncompliant adventitia. Because effects vascular compression, lack response pre-operative predictive