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[Objective results of lumbar sympathectomy. Statistical study, based on vascular function tests]

R Courbier, J M Jausseran, M Reggi

    La Nouvelle Presse Medicale
    |March 6, 1976
    PubMed
    Summary

    Low lumbar sympathectomy shows excellent results for isolated atherosclerotic lesions, improving walking tolerance and blood flow. However, it is less effective for diffuse or diabetic leg artery issues.

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    Area of Science:

    • Vascular Surgery
    • Peripheral Artery Disease

    Background:

    • Low lumbar sympathectomy is a surgical procedure to improve blood flow in the legs.
    • Its effectiveness in treating peripheral artery disease (PAD) varies depending on lesion type.

    Purpose of the Study:

    • To evaluate the outcomes of low lumbar sympathectomy in 100 unselected patients.
    • To identify patient subgroups and lesion characteristics that predict successful outcomes.

    Main Methods:

    • Patients underwent various vascular function tests, including digital plethysmography, hyperaemia tests, rheography, segmental pressure measurements, and treadmill walking tests.
    • Statistical analysis was performed to correlate test results with clinical outcomes.

    Main Results:

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  • Excellent results were observed in patients with isolated atherosclerotic lesions.
  • Increased walking tolerance and improved circulatory flow (rheographic quotient) were statistically significant positive outcomes.
  • Hillestad's hyperaemia test accurately predicted sympathectomy effects.
  • High failure rates were noted in cases with diffuse lesions, leg artery involvement, or diabetic angiopathy.

    • Conclusions:

    • Low lumbar sympathectomy is most effective for isolated femoral atherosclerotic lesions.
    • The procedure is recommended in conjunction with reconstructive aorto-iliac surgery when the deep femoral artery is the sole distal outflow.
    • Outcomes are poor for diffuse, diabetic, or distal leg artery lesions.