[Sympathectomy of the digital arteries in acro-syndromes]

Digital sympathectomy as proposed by Flatt and al. was performed on 12 Raynaud's diseases, 6 distal arteriopathy and 4 post-trauma ischemic syndrome. Operation was performed under tourniquet. The approach depends on the number of digits involved (Brünner at the proximal part of P1, transversal in the distal palmar crease, zigzag incision at the level of each intermetacarpal space). Under microscope, adventisectomy is started on a lateral side of the artery followed by the posterior side on at least 1 cm, using the adventitia avoid all direct manipulation of the vessels. Closing skin on an aspirative drainage and simple non compressive drainage is maintaining 4 days. Index pressure and arterial blood flow are measured. Results are bad for post-trauma ischemic syndrome and arteritis but encouraging in Raynaud's disease (7 patients asked for the same operation on the opposite side).