Аннотация
Objective: Raynaud's syndrome frequently presents as digital ischemia that is triggered or worsened by exposure to cold temperatures or emotional distress.Both structural and functional alterations observed in the blood vessels contribute to the vascular abnormalities documented in secondary Raynaud's syndrome.Endovascular denervation has been suggested for the management of refractive secondary Raynaud's owing to its considerable clinical outcomes.Our aim was to report a case of successful treatment using brachial artery radiofrequency endovascular denervation in a patient with secondary Raynaud's syndrome refractory to medical treatment.Case presentation: A 50-year-old woman with secondary Raynaud's syndrome was admitted to the UMC Heart Center, Astana, Kazakhstan, in 2023 because of severe bilateral upper extremity pain, digital discoloration, swelling, paresthesia, and cold intolerance refractory to pharmacological treatment.The diagnosis of secondary Raynaud's syndrome was established based on clinical manifestations, nailfold capillaroscopy findings, pulmonary fibrosis on computed tomography, and rheumatologic assessment confirming.The patient underwent multidisciplinary evaluation involving rheumatologists, cardiologists, vascular specialists, and imaging experts.Because symptoms persisted despite corticosteroid and vasodilator therapy, radiofrequency brachial artery endovascular denervation was selected.The procedure was performed using the Symplicity Spyral catheter system under moderate sedation without complications.Marked improvement in pain, numbness, swelling, and cold intolerance was observed within 24 hours after the procedure and persisted during 3-year follow-up.Conclusion Radiofrequency brachial artery endovascular denervation may represent a feasible therapeutic option in selected patients with refractory secondary Raynaud's syndrome when conservative therapy fails.Larger studies are required to confirm long-term efficacy and safety.