[Predictive value of the reactive hyperemia test as an indicator for lumbar sympathectomy]

Seventy-five patients had a lumbar sympathectomy for chronic arteritis of the lower limbs. This study was done to assess the predictive value of Hillestad's test (potential of vasodilatation) and that of the deep breath test (sympathic stimulation), realised by digital strain gauge plethysmography. Were considered a success the patients with claudication who doubled their walking distance and those with rest pain or gangrene who suffered no more or healed. Globally speaking, 49% were a success. A positive response to Hillestad's test was followed by an 83% overall success rate. For claudicants with femoropopliteal lesions the predictive success rate was 95% with a positive Hillestad's test, against 60% globally; for patients with rest pain or gangrene or with distal lesions the success probability was around 60% if Hillestad's test was positive. A negative response to Hillestad's test was always followed by a failure in diabetics. A better predictability ought to be obtained with the adjunction of a deep breath test.