PDF herunterladen
CC BY-NC-ND 4.0 · Revista Iberoamericana de Cirugía de la Mano 2024; 52(02): e147-e154
DOI: 10.1055/s-0044-1793919
Relato de Caso | Case Report

Extended Peripheral Periarterial Sympathectomy in Chronic Digital Ischemia

Artikel in mehreren Sprachen: español | English
Martín Fernando Caloia 
2   Sanatorio Mater Dei, Ciudad Autónoma de Buenos Aires, Argentina
,
Sergio Emanuel Ronconi 
1   Hospital Universitario Austral, Pilar, Buenos Aires, Argentina
2   Sanatorio Mater Dei, Ciudad Autónoma de Buenos Aires, Argentina
,
Mariana Muñoz 
1   Hospital Universitario Austral, Pilar, Buenos Aires, Argentina
,
Sofía Fernandez 
1   Hospital Universitario Austral, Pilar, Buenos Aires, Argentina
,
Hugo Fernando Caloia 
2   Sanatorio Mater Dei, Ciudad Autónoma de Buenos Aires, Argentina
› Institutsangaben
› Weitere Informationen
Auch verfügbar auf
   Lizenzen und Reprints

Abstract

Introduction In patients with chronic digital ischemia who do not respond to medical treatment, endoscopic cervical sympathectomy has its place but may be associated with postoperative compensatory hyperhidrosis. Peripheral or digital sympathectomy is technically less demanding and involves fewer complications than central or cervical sympathectomy.

Objective Evaluate the effects of extended peripheral periarterial sympathectomy in patients with chronic distal ischemia, refractory to medical treatment; and compare these results with the different reports in the literature.

Materials and Methods Retrospective, descriptive, and analytical study of a series of 14 patients treated between 2005 and 2021, who underwent extended peripheral arterial sympathectomy.

Results 11 women and 3 men with an average age of 48 years (28-63). In 11 of the 14 cases, an improvement and/or decrease in the number of ulcerated lesions was observed, and in all cases, an evident decrease in pain was observed from the first postoperative day.

Conclusions Extended peripheral periarterial sympathectomy improves and/or stops chronic digital ischemia lesions.

Keywords

Chronic Digital Ischemia - Cervical sympathectomy - Extended Peripheral Periarterial Sympathectomy

Authors' contributions

The authors Caloia Martin and Ronconi Sergio participated similarly in the writing of the work. The author Caloia Hugo is credited with mentoring and collaborating in the correction of the manuscript. Drs Sofía Fernández and Mariana Muñoz participated in the field work collecting patient data and images.




Publikationsverlauf

Eingereicht: 25. April 2023

Angenommen: 06. September 2024

Artikel online veröffentlicht:
23. Dezember 2024

© 2024. SECMA Foundation. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • Bibliografía

  • 1 Murata K, Omokawa S, Kobata Y, Tanaka Y, Yajima H, Tamai S. Long-term follow-up of periarterial sympathectomy for chronic digital ischaemia. J Hand Surg Eur Vol 2012; 37 (08) 788-793
    CrossrefPubMedSuche in Google Scholar
  • 2 Elshabrawy AA, Elkassaby M, Abdelgawad MS, Atif E, Megahed A, Regal S. Outcomes of periarterial sympathectomy in patients with digital ischemia. Vascular 2022; 30 (05) 859-866
    CrossrefPubMedSuche in Google Scholar
  • 3 Pace CS, Merritt WH. Extended Periarterial Sympathectomy: Evaluation of Long-term Outcomes. Hand (N Y) 2018; 13 (04) 395-402
    CrossrefPubMedSuche in Google Scholar
  • 4 Balogh B, Valencak J, Vesely M, Flammer M, Gruber H, Piza-Katzer H. The nerve of Henle: an anatomic and immunohistochemical study. J Hand Surg Am 1999; 24 (05) 1103-1108
    CrossrefPubMedSuche in Google Scholar
  • 5 Balogh B, Mayer W, Vesely M, Mayer S, Partsch H, Piza-Katzer H. Adventitial stripping of the radial and ulnar arteries in Raynaud's disease. J Hand Surg Am 2002; 27 (06) 1073-1080
    CrossrefPubMedSuche in Google Scholar
  • 6 Satteson ES, Chung MP, Chung LS, Chang J. Microsurgical distal sympathectomy in chronic vasospastic syndromes of the hand. J Scleroderma Relat Disord 2020; 5 (02) 130-136
    PubMedSuche in Google Scholar
  • 7 Flatt AE. Digital artery sympathectomy. J Hand Surg Am 1980; 5 (06) 550-556
    CrossrefPubMedSuche in Google Scholar
  • 8 Miller LM, Morgan RF. Vasospastic disorders. Etiology, recognition, and treatment. Hand Clin 1993; 9 (01) 171-187
    CrossrefPubMedSuche in Google Scholar
  • 9 Koman LA, Smith BP, Pollock Jr FE, Smith TL, Pollock D, Russell GB. The microcirculatory effects of peripheral sympathectomy. J Hand Surg Am 1995; 20 (05) 709-717
    CrossrefPubMedSuche in Google Scholar
  • 10 Merritt WH. Role and rationale for extended periarterial sympathectomy in the management of severe Raynaud syndrome: techniques and results. Hand Clin 2015; 31 (01) 101-120
    CrossrefPubMedSuche in Google Scholar
  • 11 Rudolph M, Butler K, Prabhu S, Browne D, Koman LA, Li Z. Revision periarterial sympathectomy for recurrent digital ischaemia: a report with 11 patients. J Hand Surg Eur Vol 2021; 46 (08) 883-890
    CrossrefPubMedSuche in Google Scholar
  • 12 Coveliers HME, Hoexum F, Nederhoed JH, Wisselink W, Rauwerda JA. Thoracic sympathectomy for digital ischemia: a summary of evidence. J Vasc Surg 2011; 54 (01) 273-277
    CrossrefPubMedSuche in Google Scholar
  • 13 Tang JB, Giddins G. Why and how to report surgeons' levels of expertise. J Hand Surg Eur Vol 2016; 41 (04) 365-366
    CrossrefPubMedSuche in Google Scholar
  • 14 Kotsis SV, Chung KC. A systematic review of the outcomes of digital sympathectomy for treatment of chronic digital ischemia. J Rheumatol 2003; 30 (08) 1788-1792
    PubMedSuche in Google Scholar
  • 15 Hartzell TL, Makhni EC, Sampson C. Long-term results of periarterial sympathectomy. J Hand Surg Am 2009; 34 (08) 1454-1460
    CrossrefPubMedSuche in Google Scholar
  • 16 Khan MI, Tariq M, Rehman A, Zafar A, Sheen SN. Efficacy of cervicothoracic sympathectomy versus conservative management in patients suffering from incapacitating Raynaud's syndrome after frost bite. J Ayub Med Coll Abbottabad 2008; 20 (02) 21-24
    PubMedSuche in Google Scholar
  • 17 Karapolat S, Turkyilmaz A, Tekinbas C. Effects of Endoscopic Thoracic Sympathectomy on Raynaud's Disease. J Laparoendosc Adv Surg Tech A 2018; 28 (06) 726-729
    CrossrefPubMedSuche in Google Scholar
  • 18 Kamiya C, Kitaoka T, Yamamoto K, Matsumoto H, Deguchi J, Sato O. Acute palmer digital artery occlusion treated using endoscopic ablation of the thoracic sympathetic. Ann Vasc Dis 2010; 3 (01) 77-80
    CrossrefPubMedSuche in Google Scholar
  • 19 Cameron A. Endoscopic thoracic sympathectomy. Eur J Vasc Endovasc Surg 2002; 23 (06) 570
    CrossrefPubMedSuche in Google Scholar
  • 20 Moraites E, Vaughn OA, Hill S. Endoscopic thoracic sympathectomy. Dermatol Clin 2014; 32 (04) 541-548
    CrossrefPubMedSuche in Google Scholar
  • 21 Johnson JP, Obasi C, Hahn MS, Glatleider P. Endoscopic thoracic sympathectomy. J Neurosurg 1999; 91 (1, Suppl) 90-97
    PubMedSuche in Google Scholar
  • 22 Coveliers H, Hoexum F, Rauwerda JA, Wisselink W. Endoscopic thoracic sympathectomy for upper limb ischemia. A 16 year follow-up in a single center. Surgeon 2016; 14 (05) 265-269
    CrossrefPubMedSuche in Google Scholar
  • 23 Lee KS, Chuang CL, Lin CL, Tsai LC, Hwang SL, Howng SL. Percutaneous CT-guided chemical thoracic sympathectomy for patients with palmar hyperhidrosis after transthoracic endoscopic sympathectomy. Surg Neurol 2004; 62 (06) 501-505 , discussion 505
    CrossrefPubMedSuche in Google Scholar