Results of Lumbar Sympathectomy in Peripheral Vascular Disease

Abstract

Tests for the possible effectiveness of sympathectomy in the treatment of peripheral vascular disease have been performed in many clinics for nearly three decades.^{16, 25,35}Various degrees of dependency have been put upon them for the selection of suitable cases for the operation. DeBakey⁹stated that the use of sympathetic block as a preliminary procedure to test the value of sympathectomy was not entirely dependable in degenerative arterial disease. Others^3,5,7,11also have reported that a lack of response following preoperative procaine block of the lumbar sympathetic chain did not consistently predict a lack of clinical response after sympathectomy. Early studies, for the most part, depended upon changes in the temperature of the skin after temporary inhibition or block of sympathetic activity. It was assumed that rises in temperature would be indicative of increases in the rate of blood flow in the skin and that similar improvements would