Assessment of the radial and ulnar arteries hemodynamic changes by ultrasound in patients with severe Raynaud′s syndrome after endoscopic thoracic sympathectomy

doi:10.3877/cma.j.issn.1672-6448.2016.08.012

Abstract

Abstract:

Objective

To assess the radial and ulnar arteries hemodynamic changes by ultrasound in patients with severe Raynaud?s syndrome (RS) after endoscopic thoracic sympathectomy.

Methods

Between December 2012 and February 2015, 13 patients with severe RS were admitted to the First Hospital of Jiaxing City, Zhejiang Province, 47 arteries of these patients who underwent endoscopic thoracic sympathectomy (T₂-T₃ segment) were enrolled into this study. Diameters (D), peak systolic velocity (PSV), end diastolic velocity (EDV) and resistive index (RI) of the radial and ulnar arteries were examined one day before and after the operation by color Doppler ultrasound. Spectral waveforms of these arteries were observed, and the affected hands? skin temperatures of these patients were measured. Paired sample t tests were used to compare D, PSV, EDV, RI and the affected hands? skin temperatures of patients with severe RS before and after the surgery.

Results

D and EDV of the radial and ulnar arteries of patients with severe RS significantly increased after surgery [D: (2.33±0.49) mm vs (2.01±0.33) mm, (1.79±0.35) mm vs (1.61±0.30) mm; EDV: (8.35±1.81) cm/s vs (4.70±1.43) cm/s, (7.96±0.94) cm/s vs (3.82±1.13) cm/s]. RI of the radial and ulnar arteries significantly decreased after surgery (0.86±0.09 vs 0.94±0.09, 0.88±0.10 vs 0.96±0.07). There were significant differences between D, EDV and RI of the radial and ulnar arteries before and after surgery (D: t=-4.17 and -2.79, all P<0.01; EDV: t=-14.57 and -16.42, all P<0.01; RI: t=2.97 and 3.07, all P<0.01). However, insignificant differences were found between PSV of the radial and ulnar arteries before and after surgery [(45.00±16.51) cm/s vs (45.37±16.10) cm/s, (45.45±21.71) cm/s vs (49.65±17.24) cm/s, t=-0.11 and -1.09, all P>0.05). Reverse flow disappeared in 3 arteries at early diastolic stage, and forward flow velocity increased in 39 arteries at end diastolic stage after surgery. The affected hands? skin temperatures of these patients with severe RS increased after surgery [(34.22±1.65)℃ vs (32.31±2.12)℃], and the differences were found significant (t=-7.92, P<0.01).

Conclusions

Endoscopic thoracic sympathectomy increase D and EDV but decrease RI of the radial and ulnar arteries in patients with severe RS to relieve spasm of the hand arteries, and increase the temperatures of the affected hands as a result. Therefore, artery D, EDV and RI measured by ultrasound can be used as parameters to evaluate the effect of endoscopic thoracic sympathectomy in patients with severe RS. It?s objective, non-invasive, and convenient.

Key words: Ultrasonography, Thoracic sympathectomy, Raynaud′s syndrome, Hemodynamics

Mingmin Xu, Weibo Qi, fan Yang, Junjie Zhao, Guping Shi, Yi Hu. Assessment of the radial and ulnar arteries hemodynamic changes by ultrasound in patients with severe Raynaud′s syndrome after endoscopic thoracic sympathectomy[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2016, 13(08): 617-621.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2016.08.012

https://chaosheng.cma-cmc.com.cn/EN/Y2016/V13/I08/617

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