Distal Peri-Arterial Sympathectomy: The Over-Ratted Option in Management of Peripheral Cyanotic Disorders

Background: Digital ischemia in upper and lower extremity, with ulceration and gangrene can be a manifestation of Raynaud’s phenomenon (RP). The early manifestation of Raynaud’s may be informed of ischemic pain and numbness, cold intolerance and in severe cases manifested as ulceration and gangrene. Aim of the study: to evaluate the results of digital sympathectomy in cases of severe ischemia of digits manifesting as digital ulceration and ischemic pain refractory to medical treatment. Patient and method: Distal sympathectomy of the ulnar and radial arteritis of the affected limb. Results: The patient developed dramatic improvement of symptoms, we were surprised for patient satisfaction and appreciation. We touched firmly the affected finger and the patient was smiling. On follow up, no return of annoying symptoms.