J.Jpn. Surg. Soc.. 60(3): 474-492, 1959

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STUDIES ON THE ETIOLOGY OF THE VASCULAR CHANGES OF THE PRESENILE SPONTANEOUS GANGRENE

No particular finding was found out from clinical statistics and blood examinations which were carried out more than several times on each of twenty-six cases of presenile spontaneous gangrene at their different stages. The symptoms due to stimulating the autonomic nervous system such as angiospasm were much severer than those due to arterial obliteration in most of these cases. The results of sympathetic block or sympathectomy in early stage were much better than those in late stage, regardless of severity of their symptoms.
The femoral vein on one side was doublly ligated just below the nguinal ligament on rabbit, so that a venous sac was made, and 0.1 cc of one per cent lead acetate solution was injected into it. About thirty days later, Winiwarter type proliferative endoarteritis was produced in the accompanying femoral artery without any changes of the tissue between the vessels. The changes of the artery and also changes in the adrenals which were seen at the sametime, were prevented when sympathetic lumbar chains were removed bilaterally or Chlorpromazine was administerted in advance. When stripping of the adventitia of the femoral artery were performed with injection of lead acetate solution into the venous sac, a Buerger type obliterative thromboangiitis was produced in the femoral artery after about thirty days.
From these clinical and experimental studies, autonomic nervous system must be considered to act a major role in the etiology of the vascular changes of presenile spontaneous gangrene.
(author's abstract)

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