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Abstract THE PROBLEM OF RELEASING VASOCONSTRICTOR TONE BY SYMPATHECTOMY Since the first attempts to relieve vasospasm in Raynaud's disease by sympathetic ramisection the results of the operation have been so variable that numerous modifications have been proposed in the technic of arterial denervation. Ganglionectomy has been found much more effective than ramisectomy because it is easier to make certain of resecting the nodal ganglia than to be sure of cutting all their delicate rami communicantes; also, because regeneration of the vasoconstrictor fibers is far less likely after this more radical but harmless procedure. Resection of the second and third lumbar ganglia is now established as a certain method for restoring an adequate circulation in favorable early cases of Raynaud's disease of the lower extremity. Twelve patients so treated at the Massachusetts General Hospital, after satisfactory response to procaine block, have all maintained an excellent circulation in the feet, with freedom from References 1. Kuntz, A.: Distribution of the Sympathetic Rami to the Brachial Plexus: Its Relation to Sympathectomy Affecting the Upper Extremity , Arch. Surg. 15: 871 ( (Dec.) ) 1927.Crossref 2. Adson, A. W., and Brown, G. E.: The Treatment of Raynaud's Disease by Resection of the Upper Thoracic and Lumbar Sympathetic Ganglia and Trunks , Surg., Gynec. & Obst. 48:577, 1929. 3. Lewis, T.: Experiments Relating to the Peripheral Mechanism Involved in Spasmodic Arrest of the Circulation in the Fingers; A Variety of Raynaud's Disease , Heart 15:7, 1929. 4. Lewis, T., and Pickering, G. W.: Observations upon Maladies in Which the Blood Supply to Digits Ceases Intermittently or Permanently, and upon Bilateral Gangrene of Digits; Observations Relevant to So-Called "Raynaud's Disease," Clin. 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Archives of Neurology & Psychiatry – American Medical Association
Published: Dec 1, 1936
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