Peripheral arterial- bypass grafts in the hand or foot in systemic sclerosis.

Although the literature suggests that sympathectomy alone may improve ischaemic digital pain, fingertip ulceration and cold intolerance in vaso-occlusive patients, questions regarding long-term efficacy remain. Two adult patients, aged 42 and 49 years, had severe digital ischaemia and ulceration in a finger and a toe, respectively, and arteriograms confirmed the occlusions of the superficial palmar arch and tarsal arch, respectively. Microsurgical re-vascularisation of the hand and foot and arch reconstruction were performed by using the greater saphenous vein for reconstruction. Following successful vascular reconstruction, digital temperatures, pain and cold sensitivity and health-related quality of life improved significantly. No recurrence has been encountered after X and Y months of follow-up.