Effects of lumbar sympathectomy on thromboangiitis obliterans

The clinical response to lumbar sympathectomy has been reported. The incidence of improvement was as follows: Coldness 52 percent, ulcer 58 percent, rest pain 64 percent, and claudication 31 percent, respectively. The blood flow in the anterior tibial muscles did not increase within 5 weeks postoperatively. There were correlations between the effects and the clinical stages, the interval from the onset to the operations, the abuse of tobacco, and the degree of reactive hyperemia, but not relation was observed between as to the site of obstruction. In the experiments, the influence of acetylcholine on blood flow increased after the operations and the duration of vasoconstriction following administration of noradrenalin became shorter. On the basis of the clinical and experimental facts, postoperative improvement seems to be due to increased blood flow to the peripheral skin and to relief of vasospasm.