Hemodynamic Consequences Of Lumbar Sympathectomy With Aortofemoral Reconstruction

Abstract

Material and Methods: Ninety-three patients with aortoiiofemoral occlusive disease underwent aortobifemoral byp ass during the 22-month period of the study. Twenty-six patients were excluded for violation of protocol or technical problems with sympathect omy. Sixty-seven patients were randomized acc ording to the last digit of their hospital number to receive bilateral lumbar sympathectomy in addit ion to aortofemoral bypass (AFB). Results: There was no statistically ence in ‘age, sex, risk factors, associated diseases, and indica between the S andNS groups. significant differ- smoking history, tion for operation SFOD was some- what more prevalent in the S group (79%) as compared to the NS group (59%) (P<.05). Discussion: Considerable controversy exists in the literat ure regarding the place of lumbar sympathectomy (S) in the treatment of lower extremity arterial disease. Refinements in reconstructive surgery have relegated S to a secOndary procedure, often performed in end stage nonreconstructible arterial disease. However, concomitant S with aortoiliac reconstruction has often been performed on an empiric basis, without objective hemodynamic data to support this practice.