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Related Experiment Videos

[Are there indications for sympatholysis using phenol?].

P Coubret, P Lermusiaux, J P Becquemin

    Journal Des Maladies Vasculaires
    |January 1, 1985
    PubMed
    Summary
    This summary is machine-generated.

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    Phenol injections for lumbar sympathetic chains in elderly patients showed poor results and significant complications. This procedure is only recommended for select cases with rest pain or ulcers and visible distal arteries.

    Area of Science:

    • Vascular Surgery
    • Pain Management
    • Interventional Radiology

    Context:

    • Elderly patients (mean age 78) with poor general condition often present contraindications for anesthesia.
    • Lumbar sympathetic chain phenol injections were explored as an alternative treatment for peripheral artery disease complications.
    • Previous treatment outcomes for this patient demographic and condition were limited.

    Purpose:

    • To evaluate the efficacy and safety of phenol injections of the lumbar sympathetic chain in elderly patients with peripheral artery disease.
    • To determine the success rates of phenol injections at one month and one year post-procedure.
    • To identify patient subgroups that may benefit from or not benefit from this intervention.

    Summary:

    • Forty-five phenol injections were performed on 40 elderly patients. The procedure had a significant complication rate (4.5% mortality, 9% serious complications) and poor success rates (42% at 1 month, 27% at 1 year).

    Related Experiment Videos

  • Outcomes were worse in patients with toe gangrene or absence of distal arteries on arteriography.
  • Diabetes mellitus did not impact the results. Optimal candidates had rest pain or ischemic ulcers with at least one visible distal artery.

    • Impact:

    • Highlights the risks and limited benefits of phenol lumbar sympathectomy in elderly, high-risk patients.
    • Emphasizes the critical need for careful patient selection, particularly the presence of distal arterial flow.
    • Suggests that this intervention should be reserved for carefully selected cases of ischemic rest pain or ulcers, not for severe gangrene without distal perfusion.