Secondary Raynaud's phenomenon can reach a level of severity that requires intravenous intervention — particularly when attacks are frequent and serious, or when the condition has progressed to digital ulceration or critical ischaemia.
Intravenous prostanoid therapy is generally reserved for patients with severe secondary Raynaud's phenomenon — especially those whose condition has advanced to digital ulceration or critical ischaemia, or who have a prior history of such episodes.
Management at this stage centres on an intravenous prostanoid agent. The choice between available agents and the complete clinical criteria guiding their use are set out in the full protocol.
The primary clinical aim is reduction in the frequency and severity of Raynaud's phenomenon attacks.