Cryodynamic hand angiography in the diagnosis and management of Raynaud's syndrome.

Cryodynamic hand angiography (CHA) with angiograms done before, just after, and during rewarming following hand immersion in ice water was performed in 39 patients with Raynaud's syndrome and eight volunteers without it. The normal response to cold stimulus was angiographically evident as mild, transient digital arterial constriction. Most of the patients with Raynaud's syndrome, in addition to organic obstructive disease, exhibited basal vasoconstriction and exaggerated persisting cryogenic vasospasm of the hand arteries. Similar angiographic studies done in 32 cases two days after the selective intra-arterial administration of reserpine revealed no differences in normal subjects but substantially decreased vasospasm in patients with Raynaud's syndrome. CHA with postreserpine studies was found to be diagnostically useful in Raynaud's syndrome, revealing the degree of organic arterial disease and functional vasospasm. In addition, correlation of postreserpine studies with observed clinical responses to long-term vasodilator drug therapy indicated that CHA has a good chance to predict the probable outcome of such therapy in Raynaud's syndrome.