THE PROBLEM OF RELEASING VASOCONSTRICTOR TONE BY SYMPATHECTOMY
Since the first attempts to relieve vasospasm in Raynaud's disease by sympathetic ramisection the results of the operation have been so variable that numerous modifications have been proposed in the technic of arterial denervation. Ganglionectomy has been found much more effective than ramisectomy because it is easier to make certain of resecting the nodal ganglia than to be sure of cutting all their delicate rami communicantes; also, because regeneration of the vasoconstrictor fibers is far less likely after this more radical but harmless procedure. Resection of the second and third lumbar ganglia is now established as a certain method for restoring an adequate circulation in favorable early cases of Raynaud's disease of the lower extremity. Twelve patients so treated at the Massachusetts General Hospital, after satisfactory response to procaine block, have all maintained an excellent circulation in the feet, with freedom from
WHITE JC, OKELBERRY AM, WHITELAW GP. VASOMOTOR TONUS OF THE DENERVATED ARTERY: CONTROL OF SYMPATHECTOMIZED BLOOD VESSELS BY SYMPATHOMIMETIC HORMONES AND ITS RELATION TO THE SURGICAL TREATMENT OF PATIENTS WITH RAYNAUD'S DISEASE. Arch NeurPsych. 1936;36(6):1251–1276. doi:10.1001/archneurpsyc.1936.02260120098007
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