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J Reconstr Microsurg 2002; 18(4): 263-268
DOI: 10.1055/s-2002-30181
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Rationale for and Efficacy of Digital Arterial Reconstruction in Scleroderma: Report of Two Cases

Matthew M. Tomaino1 , John King2 , Thomas Medsger3
  • 1Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA
  • 2Lakelands Orthopaedic Clinic, Greenwood, SC
  • 3Department of Rheumatology, University of Pittsburgh Medical Center, Pittsburgh, PA
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Publication History

Publication Date:
17 May 2002 (online)

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ABSTRACT

Two patients with scleroderma, ischemic pain, non-healing digital ulceration, and digital arterial obstruction were successfully treated with peripheral sympathectomy and digital arterial reconstruction using a reversed small-caliber vein graft. Postoperatively, digital blood flow increased and ulceration healed in both patients. Peripheral sympathectomy alone may not adequately improve digital perfusion, when the benefits of decreased vasospasm are offset by the presence of digital arterial insufficiency. When technically feasible, digital arterial reconstruction improves digital blood flow in scleroderma patients in whom digital collateral circulation appears inadequate after sympathectomy.

KEYWORDS

Scleroderma - digital arterial reconstruction

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