Cor Vasa 2007, 49(1):13-18 | DOI: 10.33678/cor.2007.008

Radiofrequency thoracic sympathetic denervation a new option in the treatment of ischemic upper limb conditions

Pavel Michálek^1,*, Tomáš Gabrhelík², Libor Doleček¹, Petr Štádler³, Pavel Šebesta³, Karel Roztočil⁴

¹ Úsek kardiovaskulární anestezie a intenzivní péče, Nemocnice Na Homolce, Praha

² Klinika anesteziologie a resuscitace, Fakultní nemocnice Olomouc a Lékařská fakulta Univerzity Palackého, Olomouc

³ Oddělení cévní a rekonstrukční chirurgie, Nemocnice Na Homolce, Praha

⁴ Klinika kardiologie, Institut klinické a experimentální medicíny, Praha, Česká republika

Background:
The aim of this pilot study was to evaluate the success rate of percutaneous radiofrequency thermolesion in the treatment of ischemic upper limb conditions.

Methods:
Twenty selected patients underwent radiofrequency thermolesion of the upper thoracic sympathetic chain using controlled lesion at the level of T2 and T3. The success rate of the procedure was evaluated using both subjective and
objective methods as well as the frequency of complications.

Results:
Ninety percent of patients reported improvement of upper extremity peripheral circulation in the acute phase. Twenty-eight percent of patients reported recurrence of the ischemic condition. A beneficial effect of the procedure was noted in more than 75% of patients after 2 years. No deaths or major complications were reported. Non-significant adverse effects of the procedure included temporary backache and upper limb swelling due to reperfusion.

Conclusions:
Percutaneous radiofrequency upper thoracic sympathectomy seems to be effective treatment of ischemic
conditions of the upper extremities. Additional studies are needed to confirm these findings.

Keywords: Upper limb ischemia; Radiofrequency thermolesion; Upper thoracic sympathetic chain

Published: January 1, 2007  Show citation