Long-term outcomes of vascular grafting of medium-sized vessels of wrist and hand in systemic sclerosis patients with medication refractory Raynaud's

Early human evidence such as case series or small samples is exploring possible benefits.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Objective: Systemic sclerosis is characterized by vasculopathy at the microvascular level and less commonly the macrovascular level. The vasculopathy in systemic sclerosis, based on its functional and structural changes, leads to symptoms of vasospasm (Raynaud's phenomenon) and tissue injury. In most cases, preventive actions and pharmacotherapy provide beneficial treatment options; however, in severe cases, painful ulcerations, gangrene, and digital amputations may occur with treatment. In medication refractory cases, revascularization of medium and small vessels has been pursued. Other studies regarding long-term outcomes of revascularization of systemic sclerosis-Raynaud's patients are less reported. Methods: Patients at the University of Pennsylvania (2009-2022) were identified with International Classification of Diseases (ICD)-9 and ICD-10 diagnosis codes for systemic sclerosis (ACR/EULAR 2013 criteria), Raynaud's phenomenon, and vascular grafting. Retrospective assessment of preoperative and postoperative patient-reported symptoms (Raynaud's symptoms, pain, ulcers), exam findings, and imaging results were collected. Results: Twelve hands from 10 patients were identified. Nine patients had limited systemic sclerosis, and one patient had diffuse systemic sclerosis. Eight patients were female, and the average surgery age was 52.3 ± 17.7 years. Vessel occlusion and revascula

Evidence level

Early human evidence such as case series or small samples is exploring possible benefits.

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