Raynauds Clinical Trial
Official title:
Single-port Thoracoscopic Sympathicotomy for Treatment of Raynaud's Phenomenon, a Feasibility Study
The goal is to investigate the effect of a single-port R3 sympathicotomy on microvascular circulation in the affected fingers. This effect is analysed by performing cooling plethysmography and nailfold capillary microscopy bilaterally, following a unilateral, single-port thoracoscopic sympathicotomy.
Raynaud's phenomenon is discoloration, discomfort and numbness or pain in the fingers and
toes as a result of excessively reduced blood flow due to sympathetic induced vasospasms, in
response to a change in temperature or emotional stress. It usually affects multiple fingers
of both hands and comes in frequent attacks, with little or no discomfort in between them.
Current treatment consists of stepped-care, including preventive measures optimizing digital
blood flow, oral and intravenous medical therapy aimed at improving microvascular
circulation, surgical neuromodulation to achieve vasodilatation and neurostimulation.
While surgical sympathectomy is an established treatment of Raynaud's phenomenon, its more
invasive nature has prevented widespread application as an initial therapy. After
introduction of minimally invasive surgical techniques in recent years, the investigators
have further optimized the endoscopic sympathicotomy procedure performed on hyperhidrosis
patients, now needing only a single 1 cm port for a detailed, panoramic view of the
sympathetic chain (1). This minimal invasive technique has proven to be a safe, efficient and
reproducible treatment for several indications and seems also suitable for Raynaud's
patients.
In this feasibility study, the researchers want to investigate the effect of a single-port R3
sympathicotomy on microvascular circulation in the affected fingers. This effect is analysed
by performing cooling plethysmography and nailfold capillary microscopy bilaterally,
following a unilateral, single-port thoracoscopic sympathicotomy.
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