Recent advances in the management of arterial insufficiency in extremities have come largely as a result of better understanding of the pathologic physiology of the peripheral circulation and recognition of the more important factors which alter the delicate functional balance in the peripheral vascular bed. Disturbances in the peripheral circulatory balance greatly interfere with the natural ability of the vascular system to respond properly to the usual physical changes in the environment.
Active inflammation of the arteries or the veins in an extremity may provoke vasomotor instability in the entire limb and occasionally in all four extremities. In the early stages of peripheral angiitis, abnormal susceptibility to mild degrees of cold may be the only clinical evidence of inflammatory involvement of the arteries and veins; yet if the true nature of such an underlying process is not recognized or if adequate therapy is delayed too long, serious structural changes in
HERRMANN LG, McGRATH EJ. EFFECT OF ESTROGENS ON VASCULAR SPASM DUE TO ACTIVE ANGIITIS IN THE EXTREMITIES. Arch Surg. 1940;40(2):334-343. doi:10.1001/archsurg.1940.04240010174012