Long-term results of arterial sympathectomy and artery reconstruction with vein bypass technique as a salvage procedure for severe digital ischemia.

Abstract

The aim of this study is to present a combined treatment of arterial sympathectomy and artery reconstruction with vein bypass technique in patients with severe digital ischemia. In all, 22 patients representing 53 digits received treatment during a 15-year period. Skin color and trophic changes including ulcers, necrosis, and amputation; pain level according to the visual analog scale; and functional assessment based on the disabilities of the arm, shoulder, and hand questionnaire were recorded. After surgery, the skin discoloration improved, and the trophic changes healed in the majority of patients. Amputation was required in 2 cases. Pain and function improved significantly postoperatively. Based on the results of this study, vascular reconstruction combined with sympathectomy may be indicated on an individualized basis for patients with digital ischemia. This procedure can lead to healing of skin trophic changes, diminution of pain, avoidance of amputation, and long-term improvement in life quality.