Commentary on Murata et al. Long-term follow-up of periarterial sympathectomy for chronic digital ischaemia

摘要

This is a long-term follow-up review in a relatively small sample size of patients with chronic digital ischaemia, no ulceration or gangrene, and mixed aetiology. The surgery involved an adventitial stripping of both proximal (radial and ulnar) and distal (common digital) arteries as originally described by Flatt and then refined by Wilgis, O'Brien, and more recently, Koman. The patients were followed for a minimum of 10 years, with peak of recovery recorded at approximately 3 years post-operatively, beyond which there was no significant improvement sympto-matically. Objective investigations such as angiogra-phy, thermography, and plethysmography showed variable outcomes and are not necessarily reliable predictors of outcome.