SURGICAL INTERVENTION ON THE SYMPATHETIC NERVOUS SYSTEM FOR PERIPHERAL VASCULAR DISEASE

Abstract

Since the work of Royle and that of Hunter¹on the relation between the sympathetic nervous system and spastic paralysis, it has become obvious that a striking and persistent increase in blood flow follows interruption of sympathetic pathways to the extremities. Although previous attempts to increase peripheral blood flow by periarterial sympathectomy²had been followed by transient improvement, lumbar ramisectomy as practiced by Royle³and by Hunter¹resulted in a more prolonged effect. This observation was the stimulus for extensive study of the relation between the sympathetic nervous system and the peripheral circulation. During the past fifteen years much has been learned about the anatomy and physiology of the sympathetic nervous system.⁴Clinical application of this knowledge to the treatment of various peripheral vascular disorders now appears to be well established. FUNDAMENTAL PRINCIPLES Out of the tremendous amount of clinical and experimental evidence collected in