Hemodynamic Consequences of Lumbar Sympathectomy with Aortofemoral Reconstruction

Abstract

Material and Methods: Ninety-three patients with aortoiliofernoral occlusive disease underwent aortobifemoral bypass during the 22 month period of the study: Twenty six patients were excluded for violation of protocol or technical problems with sympathectomy. Discussion: Considerable controversy exists in the literature 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 nonreconstructihie arterial disease. Clinical experience suggests that S alone is of value in properly selected patients with end stage arterial disease and nonhealing ischemic ulcerations. The present study fails to demonstrate convincing evidence of its efficacy when used as an adjunct to aortofemoral bypass, with a mean follow-up period extending to one year.