Extirpation of the stellate ganglion or section of the gray rami which connect this ganglion with the brachial plexus has become a recognized surgical procedure, especially in diseases involving the blood vessels of the upper extremity. The aim of this procedure in diseases of the blood vessels is vasomotor denervation of the extremity. Extirpation of the stellate ganglion alone, or section of the gray rami which connect it with the brachial plexus, however, does not completely eliminate the sympathetic nerves of the upper limb in a large percentage of cases. The operation has failed to produce the desired results in certain cases, probably because of incomplete sympathetic denervation of the blood vessels which were involved.
During the progress of studies involving the gray rami associated with the brachial plexus and the distribution of sympathetic fibers in the upper extremity, my attention was called to the inconstant intra-thoracic ramus that connects
KUNTZ A. DISTRIBUTION OF THE SYMPATHETIC RAMI TO THE BRACHIAL PLEXUS: ITS RELATION TO SYMPATHECTOMY AFFECTING THE UPPER EXTREMITY. Arch Surg. 1927;15(6):871–877. doi:10.1001/archsurg.1927.01130240044003
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