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[Distal arteritis of the legs: lumbar sympathectomy]

M Vayssairat1, P Gouny, N Baudot

  • 1Service de Chirurgie vasculaire, Hôpital Rothschild, Paris.

Journal Des Maladies Vasculaires
|January 1, 1994
PubMed

Insights

Lumbar sympathectomy is a potential treatment for chronic lower limb arterial occlusions, but its effectiveness lacks confirmation from controlled trials. Further evaluation is needed for specific patient groups with ischemic foot ulcers.

Area of Science:

  • Vascular Surgery
  • Arterial Disease Management

Context:

  • Chronic sub-popliteal arterial occlusions are a diverse group of patients with atheromatous disease.
  • Lumbar sympathectomy is a traditional treatment option for this condition.
  • The efficacy of lumbar sympathectomy has not been validated by controlled randomized trials.

Purpose:

  • To review the indications and contraindications for lumbar sympathectomy in chronic lower limb arterial occlusive disease.
  • To identify patient subgroups that may benefit from lumbar sympathectomy.
  • To advocate for controlled trials to evaluate lumbar sympathectomy's effectiveness.

Summary:

  • Lumbar sympathectomy is a classical treatment for chronic sub-popliteal arterial occlusions.
  • Current evidence does not support its use based on controlled trials.
  • Contraindications include asymptomatic patients, claudication, critical ischemia, limb salvage, and combined vascular surgery.

Impact:

  • Highlights the need for evidence-based evaluation of established surgical procedures.
  • Suggests a specific patient profile (small ischemic foot ulceration without critical ischemia) for future controlled studies.
  • Aims to refine treatment strategies for atheromatous occlusive arterial disease of the lower limbs.

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