Indications for angiography and its optimal performance in patients with Raynaud's phenomenon

Fifty-two patients with Raynaud's phenomenon of the upper extremity were examined by angiography because of suspected organic stenosis or occlusions in areas available for reconstructive vascular surgery. Different vasodilatating treatments were compared either singly or combined: blockade of the brachial plexus, intraarterial injections of phentolamine or reserpine, body warming, and orally administered alcohol. Body warming in combination with 4 mg phentolamine gave optimal vasodilatation within the shortest time and without vasospasm after local cold provocation in patients with sympathetically induced vasospasm, enabling a clear visualization of organic lesions. A proper vasodilatation was also obtained after blockade of the brachial plexus or reserpine injection combined with body warming, but not until 40 min after the start of the treatments.