Raynaud

1
Raynauds syndrome ?? ? Hot bag?   ???? ?? ??
? ??. ???. ? ??. ? ??. ? ??. ????? ??? ??????
?? ???
2
Raynauds syndrome, phenomenon

• ? ??? ?? ?? ??? ???? ??? ???, ???? ????? ??? ????
  ?? ? ??? ???? ??
• Raynaud phenomenon? ??? ??? ??? ?? ??? ????? ???
  ??? ???? Rheumatoid arthritis , Buergers
  disease, ??? ??? ?? ?? ?? ??? ???

3
Raynauds syndrome of Cause

• ??
• ????? ??
• Attack
• ??
• Ulceration, Gangrene,
• Amputation (in severe cases)

4
Raynauds syndrome of symptoms
Color-change, cyanosis
5
Purpose

• Raynauds syndrome? Peripheral artery ???? ???
  Upper/Lower Extremity Angiogram? ?? ???? ????
  ???? ?? ??? ???? ?? ????
• ???? ??? ?? Hot Bag? ??? ?? ?? ?? ??? ???? ? ??
  ??? ?? ??? ??.

6
Patients

• 2001?1? 2002? 12??? ? ??? ??? ?? ??? ?? ? ??
  ????? Upper/Lower Extremity Angiogram? ??? ???
  ???? ??
• ?? ? Hot Bag? application? ??? ??? ?? ??? ??
  ?????.

7
Methods

• ABI (Ankle-Brachial Index)
• systolic pressure of ankle/systolic pressure
  of arm
• (Normal gt
  1.0)
• DITI (digital infrared thermal image)
• Angiogram (Hot Bag application)

8
D.I.T.I.
area Low High Avg.
A 26.47 29.61 27.91
B 33.14 34.31 33.75
C 28.92 31.57 30.77
D 32.45 34.12 33.46
E 28.04 31.47 30.09
F 31.47 34.51 33.01
area Low High Avg.
A 30.78 32.16 31.55
B 24.50 32.75 28.32
C 31.00 32.08 31.59
D 28.10 30.35 29.74
E 30.33 33.90 32.81
F 24.50 30.33 27.00
9
Angiogram methods

• PHILIPS INTEGRIS V3000
• Femoral artery approach ? Peripheral artery?
  Catheter, Head hunter Catheter? ???? upper/lower
  extremity angiogram??
• ??? ?- Hand 15cc, foot 25cc
• Catheter tip? ?? Hand Brachial artery
• Foot Femoral
  artery
• Angiogram ?? ? foot ?? hand? 60? Hot Bag? ?? 5??
  ?? ? ?? ??(????,????)?? angiogram? ??

10
Hot Bag application
60?
11
Angiogram
Before
12
Angiogram
After
13
Angiogram
Before
After
14
Results

• Hot Bag? application? ??, Raynauds syndrome??
  ??? ??? 45?, ??? ?? ??? 3??? ???.
• ??? ?? ??? ??? Buergers disease? Hot Bag?
  application? ??? 2?, ??? ?? ??? 12??? ???.

15
??? ? ??
None Hot Bag
Normal 35 5
Buergers dis. 12 2
Raynauds synd. 3 45
16
Raynauds syndrome? ?? ? ??
17
Raynauds syndrome? ?? ? ??
18
Conclusion

• Cold? Emotional stress? ?? ?? ??(palmar and
  digital arteries)? ???? Raynauds syndrome?
• ????? capillaries? venules? ???? ???? ????
  Ulceration? gangrene? ????? ?? ?? ? ? ????
• Raynauds syndrome? ????? ?? Hot bag application?
  ?? ??? ???? ???? ?? ???? ??? ?? ???? ?? ? ? ???.

19
Treatment

• ?? ??? ??? ??? ?? ??, ??
• ?? ?? ??? (guanethidine, methyldopa, reserpine
  ,PGE1)?? ?? ??? ?? ??,
• ??? ???? ???????? ?? ???? ?? ?? ??.
• ????? ???(?? ???????, ?? ?? ?????)?? --??? ????
  ???? ????? ?? ?? ???? ??

20
?? ???.