PMID: 11901385Mar 20, 2002Paper

Periarterial sympathectomy in scleroderma patients: intermediate-term follow-up

The Journal of Hand Surgery
D S RuchL A Koman

Abstract

The use of periarterial sympathectomy (PAS) to manage chronic digital ischemia caused by scleroderma remains controversial. The duration of efficacy of PAS in managing scleroderma symptoms was evaluated by examining microvascular physiology, health-related quality of life, and patient satisfaction. Twenty-two patients (29 hands) with scleroderma, chronic vascular insufficiency, and a history of nonhealing digital ulcers unresponsive to nonsurgical treatment were evaluated. Isolated cold stress testing and laser Doppler fluxmetry measurements were used to evaluate microvascular perfusion before surgery and after a mean follow-up period of 31 months (range, 7-108 months). Digital temperatures did not change after surgery, but microvascular perfusion had increased significantly at a mean of 31 months in 22 hands. Health-related quality-of-life data were collected at a mean of 46 months (range, 11-108 months) after surgery. Subjective improvement (fewer ulcers, faster ulcer healing, and decreased pain) was reported for 18 of 22 patients (24 of 29 hands) at a mean follow-up period of 46 months; 6 patients remained ulcer free. Follow-up of scleroderma patients after PAS documented improved microvascular perfusion as evaluated by lase...Continue Reading

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Citations

Feb 7, 2003·The Journal of Bone and Joint Surgery. American Volume·Peter C Amadio, UNKNOWN Council of Musculoskeletal Specialty Societies (COMSS) of the American Academy of Orthopaedic Surgeons
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Oct 29, 2011·Clinics in Plastic Surgery·William C Pederson, Michael W Neumeister

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