[Current indications for lumbar sympathectomy in obstructive arteriopathies of the lower extremities]

Reference is made to personal experience (421 lumbar sympathectomies in 1640 vascular operations carried out over the last ten years) and the results of an enquiry addressed to more than 200 Italian surgeons are cited for the proposition that the indications for this operation are still the subject of disagreement, while its results occasionally appear to be contradictory. It is felt that the procedure is best reserved for cases in the second initial or intermediate stage, and should only be employed in advanced 2nd-stage, and 3rd and 4th stage patients whose poor general condition is a contraindication to reconstruction (indication of necessity). Other parameters to be taken into consideration include: age, site and type of the obliterating disease, ineffectiveness of drug management, and concomitant diseases (if any). Sympathectomy plus reconstructive surgery should only be used in cases where the run-off seems unsatisfactory.