[Flowmeter monitoring following lumbar sympathectomy]

Lumbar sympathectomy is still a subject for debate with respect to its results and mechanism of action. Effects were assessed objectively by measuring hemodynamic parameters of blood flow. The study protocols are discussed. Muscle nutritional capillary flow was determined by clearance of radioactive Xenon. Within a period varying from 8 to 24 months. 31 to 51% of patients with arteritis show increased muscle flow after sympathectomy. Effects are analyzed as a function of site of lesion, duration of claudication and uni- or bilateral operation performed. The non-invasive electromagnetic flowmeter measures global pulsatile arterial blood flow in the upper third of the leg: improvement in pulsatile flow was noted in 86% of cases six months after sympathectomy. Finally, skin microcirculation velocity was measured by Doppler using a laser beam: improvement occurred immediately after sympathectomy for well defined clinical indications, whereas no effect was noted in arteriopathy of diabetic origin. This method can therefore clarify mechanisms of action of sympathectomy and justify its indications.