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Updated: May 12, 2026

Modified Octopus Technique for Thoracoabdominal Aortic Aneurysm
Published on: August 1, 2025
Acute palmer digital artery occlusion treated using endoscopic ablation of the thoracic sympathetic
Chiaki Kamiya1, Tadashi Kitaoka, Kota Yamamoto
1Department of Vascular Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
Abstract:
Acute occlusion of the digital arteries frequently causes painful infarction requiring digital amputation. We describe a 55-year-old male patient who presented with acute onset of digital ischemia with impending gangrene on the right hand. Because angiography revealed bypass surgery was not feasible, he underwent thoracoscopic sympathectomy (TS) one week after onset of the symptom, which resulted in rapid pain resolution. He was diagnosed, thereafter, with malignant rheumatoid arthritis and methotrexate was administered. Postoperative angiography revealed that the occluded digital artery had become recanalized. Timely TS is therefore a treatment of choice for acute digital ischemia.
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