STENOSIS OF THE SUBCLAVIAN VEIN - AN UNKNOWN CAUSE OF RESISTANT REFLEX SYMPATHETIC DYSTROPHY

Reflex sympathetic dystrophy (RSD) represents a neurovascular pain syn drome involving all tissues of the affected area of an extremity follo wing trauma, surgical procedures, and local as well as more centrally localized diseases. The initiating causes, however, result in a dystro phy only if increased sympathetic activity and a so-called individual predisposition exist. The cause for this up-to-now unexplored diathesi s has been explained as an impairment of the venous run-off attributab le to stenosis of the subclavian vein, which, with an appropriate incr ease of the arterial flow, leads to venous stasis and finally to an ac ute edema of the hand. This finding is essential not only for the furt her explanation of the pathogenesis and prognosis of RSD but also for the possibility of a successful surgical treatment of resistant dystro phies.