J Korean Radiol Soc. 2004 May;50(5):337-342. Korean.
Published online May 31, 2004.
Copyright © 2004 by The Korean Society of Radiology
Original Article

Effect of Hot Bag Application on the Extremities in Angiography of Patients with Raynaud's Syndrome

Je Hwan Won, Kyong Lim Han and Chan Kim1
    • Department of Diagnostic Radiology, College of Medicine, Ajou University, Korea.
    • Department of Anesthesiology and Pain Medicine, College of Medicine, Ajou University, Korea.

Abstract

Purpose

It is sometimes difficult to evaluate the angiographic findings pertaining to spasm of the arteries in the hands and feet in patients with Raynaud's syndrome. The purpose of this study is to investigate the effectiveness of applying a hot bag to the hands and/or feet for the control of vasospasm in patients with Raynaud's syndrome during angiography.

Materials and Methods

Forty five cases (hands: feet=15:30) in forty patients (M:F=9:31, mean age; 39 years) with Raynaud's syndrome whose conventional angiography demonstrated the presence of vasospasm were included. First, digital subtraction angiography of the extremities was performed at room temperature (20 to 21 ℃elsius). Then a hot bag was applied for 5 minutes on the hand or foot, and a post-hot bag angiography of the extremity was performed. The angiographic findings were classified into 6 grades in the case of the feet (0; anterior/posterior tibial artery, 1; dorsalis pedis /lateral plantar artery, 2; arcuate artery/plantar arch, 3; metatarsal artery, 4; digital artery, 5; blushing of toe tip) and 5 grades in the case of the hands (0; ulnar/radial artery, 1; palmar arch, 2; common palmar artery, 3; proper palmar artery, 4; blushing of finger tip) according to the level of the visualized vessels on the angiography. The time and the time difference to maximal visualization of the vessels between the measurements taken at room temperature and those taken after the hot bag application were calculated.

Results

In all cases, more vessels were visualized after the hot bag application than at room temperature. After the application of the hot bag, the grade of vessel visualization was increased in both the feet (range; 1-4, mean; 2.3) and hands (range; 1-2, mean; 1.4). The time to the maximal visualization of the vessels was faster after the hot bag application than at room temperature. The time difference between the two groups ranged from 1 to 33 seconds (mean; 12.3 seconds) in the feet and 2 to 26 seconds (mean; 11.8 seconds) in the hands.

Conclusion

Angiography of patients with Raynaud's syndrome showed that the application of a hot bag provides a convenient and effective method of relieving the vasospasm of the vessels of the hands or feet.

Keywords
Raynaud's syndrome; Digital subtraction angiography; Extremities


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