[Primary and secondary Raynaud's syndrome].

In the light of practical considerations a distinction is necessary between vasospastic and occlusive disease of hand and finger arteries. The vasospastic condition is usually termed Raynaud's disease and leads to recurrent ischemic attacks affecting the fingers, with early onset in life. In most instances, organic occlusions of peripheral arteries develop without initial vasospastic symptoms (exception: patients with collagen vascular disorders). Measurements of finger blood flow reported in this review show that vasospastic Raynaud's disease may be considered a variant of physiologic flow behavior in young women. Only in severe cases do cold stimuli precipitate long-lasting periods of non-measurable finger flow (venous occlusion plethysmography with finger strain gauges). In 109 personal observations the possible etiologic factors involved in organic finger artery occlusions are analyzed. They include a broad spectrum (arteriosclerosis obliterans, endangitis obliterans, collagen vascular disease, thrombocytosis, chronic occupational trauma, cryoglobulinemia). Therapy is directed at the underlying disease and the specific situation. In cases with severe ischemic symptoms, sympathectomy, intraarterial injections of reserpine, and treatment with Ancrod or fibrinolytic agents should be considered.