A gap in the evidence – What is the role of surgery in the patient with severe (secondary) Raynaud’s phenomenon?
21 May, 15 | by BMJ
by Ariane Herrick and Lindsay Muir
People with Raynaud’s phenomenon secondary to an underlying disease or condition (the best researched one being systemic sclerosis) can progress to irreversible tissue injury with ulceration and/or critical ischaemia and gangrene. Although there has been increasing interest in recent years in identifying new drug therapies for severe Raynaud’s phenomenon with randomised controlled trials (RCTs) of, for example, phosphodiesterase inhibitors and endothelin receptor antagonists, the recent BMJ Clinical Evidence overview identified no RCTs of any of the surgical procedures that have been advocated for advanced peripheral vascular disease. more…