[Microsurgical intervention in a case of Raynaud's gangrene]

In a case of typical Raynaud's gangrene a microsurgical therapeutic intervention has been tried. To interrupt the periarterial sympathetic nerve network, 1,5-2 cm of both collateral arteries of the affected right index finger were excised and replaced by two venous grafts. In addition both collateral nerves were dissected and reanastomosed for elimination of sensation and pain for some time. In the early postoperative time the patient was free of pain and started using the finger during daily life. 6 weeks after the operation a control-angiography was performed and since that moment the patient complained again of severe pain in the affected finger. The angiography had led to vascular spasm with consequent thrombosis of the patent ulnar venous graft. Because of the severe pain in the finger we were forced to amputate the finger.