Phenol lumbar sympathectomy in severe arterial disease of the lower limbs: a hemodynamic study

The indications, results and evaluation methods of lumbar sympathectomy are very controversial. The authors present their experience and results with phenol lumbar sympathectomy (PLS). PLS (Reid's technique) was carried out in 25 patients with severe peripheral arterial disease. Sympathetic tone abolition was achieved in 72% of the patients, with a beneficial clinical effect in 60%. In this group, the following measurements were made, before sympathectomy, and 24 hours, one week and one month after it: Doppler ankle-pressure, ankle-arm pressure index and calf and foot arterial flow measured with an impedance plethysmograph (IPG), at rest and after controlled exercise. The IPG-measured arterial flow in the resting foot was the only parameter to show a significant increase following PLS (p less than 0.05). Although the IPG calf flow, ankle-pressure and ankle-arm index showed increases, these were not significant. Lumbar sympathectomy by phenol injection is as effective as by surgery. Its beneficial effect is believed to be due to an increase in the resting flow in the foot.