Radiofrequency upper thoracic sympathectomy in the treatment of critical upper limb ischemia--a case series.

Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia · 2013 · Benefit · Very low evidence

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BenefitVery low evidencePaper 3198

Study snapshot

PublicationBiomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia · 2013

Study typecase_report

Reported directionBenefit

Evidence ratingVery low

Abstract

BACKGROUND: Patients with significant medical and social problems resulting from impaired perfusion of the upper limbs caused by micro- or macro-angiopathy are now frequent in clinical practice. Vasospastic disease of the upper limbs of combined origin is a difficult condition to treat by conservative methods and therapeutic strategies are usually multidisciplinary. In addition to standard pharmacotherapy, treatment may involve regional anaesthesia, thoracoscopic or radiofrequency sympathectomy and surgical treatment of defects, including plastic surgery. METHODS: This paper describes our successful work in the treatment of upper limb critical ischemia using radiofrequency upper thoracic sympathectomy. RESULTS: In three case reports we present the results of radiofrequency thermolysis applied to treat patients with chronic defects of the hand and fingers. These patients were diagnosed with upper limb critical ischemia of combined origin, standard conservative treatment methods failed and surgical intervention was originally not indicated, however, radiofrequency thermolysis proved to be beneficial. CONCLUSIONS: Radiofrequency thoracic sympathectomy could improve peripheral perfusion of the upper limbs and thereby contribute to healing of chronic defects, reduction of pain and improvement in the quality of life of the patients.

Machine Enhanced Logic

AI evidence extraction

Structured fields below were generated from the paper’s abstract and metadata to make the evidence easier to inspect. Automated extraction may be incomplete or incorrect; verify important details against the original paper.

Study typecase_report

Effect directionbenefit

PopulationPatients with upper limb critical ischemia of combined origin and chronic defects of the hand/fingers

Sample size3

ExposureNot supplied

Evidence strengthVery lowConfidence: 74% · Peer reviewed: yes

Main findings

Three case reports describe radiofrequency upper thoracic sympathectomy (radiofrequency thermolysis) in patients with upper limb critical ischemia where conservative treatment failed and surgery was initially not indicated. The intervention was reported as beneficial, with suggested improvements in peripheral perfusion, healing of chronic defects, pain reduction, and quality of life.

Outcomes measured

peripheral perfusion of upper limbs
healing of chronic defects (hand/fingers)
pain reduction
quality of life

Limitations

Case series/case reports design
Very small sample size (n=3)
No control/comparator group described
Limited exposure details (e.g., frequency, dose) not reported in abstract

View raw extracted JSON

{
  "study_type": "case_report",
  "exposure": {
    "band": null,
    "source": "radiofrequency (thermolysis/sympathectomy)",
    "frequency_mhz": null,
    "sar_wkg": null,
    "duration": null
  },
  "population": "Patients with upper limb critical ischemia of combined origin and chronic defects of the hand/fingers",
  "sample_size": 3,
  "outcomes": [
    "peripheral perfusion of upper limbs",
    "healing of chronic defects (hand/fingers)",
    "pain reduction",
    "quality of life"
  ],
  "main_findings": "Three case reports describe radiofrequency upper thoracic sympathectomy (radiofrequency thermolysis) in patients with upper limb critical ischemia where conservative treatment failed and surgery was initially not indicated. The intervention was reported as beneficial, with suggested improvements in peripheral perfusion, healing of chronic defects, pain reduction, and quality of life.",
  "effect_direction": "benefit",
  "limitations": [
    "Case series/case reports design",
    "Very small sample size (n=3)",
    "No control/comparator group described",
    "Limited exposure details (e.g., frequency, dose) not reported in abstract"
  ],
  "evidence_strength": "very_low",
  "confidence": 0.74,
  "peer_reviewed_likely": "yes",
  "keywords": [
    "radiofrequency",
    "upper thoracic sympathectomy",
    "thermolysis",
    "critical upper limb ischemia",
    "vasospastic disease",
    "microangiopathy",
    "macroangiopathy",
    "hand defects",
    "finger defects"
  ],
  "suggested_hubs": []
}

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AI-extracted fields are generated from the abstract and metadata and may be incomplete or incorrect. This material is for informational purposes and is not medical advice.

Identifiers and source

DOI: 10.5507/bp.2011.055
PubMed: 22660208

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