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Thoracoscopic sympathicotomy for arterial insufficiency.

Arterial insufficiency of the hands due to vascular spasm-morbus Raynaud is an extremely unpleasant condition. Elicited by cold temperatures, the disease can make it impossible for the patient to go out in cold environments. The condition seldom leads to skin necrosis, which is the case in arterial insufficiency caused by vascular occlusion. In both cases arterial insufficiency may be diminished by thoracic sympathectomy. Our test series of operations included 14 patients with m. Raynaud or vascular occlusion. All experienced improvement, with warm, dry hands and satisfactory healing after thoracoscopic sympathicotomy. However, after six months, the original symptoms recurred in all the patients with m. Raynaud, while the improvement continued in the patients with vascular occlusion during the two to four year period of observation.