BACKGROUND: Patients with significant medical and social pro Blems resulting from impaired perfusion of the upper lim Bs caused By micro- or macro-angiopathy are now frequent in clinical practice. Vasospastic disease of the upper lim Bs of com Bined 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 descri Bes our successful work in the treatment of upper lim B 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 lim B critical ischemia of com Bined 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 lim Bs and there By contri Bute to healing of chronic defects, reduction of pain and improvement in the quality of life of the patients.

Department of Anaesthesia Resuscitation and Intensive care medicine 1st Medical Faculty Charles University and General University Hospital Prague

Department of Anaesthesiology and Intensive Care Medicine University Hospital Olomouc and Faculty of Medicine and Dentistry Palacky University Olomouc Czech Republic

Department of Plastic and Aesthetic Surgery University Hospital Olomouc and Faculty of Medicine and Dentistry Palacky University Olomouc

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