Value of concomitant sympathectomy in aortoiliac reconstruction. Results of a prospective, randomized study
R. W. Barnes, W. H. Baker, G. Shanik, W. Maixner, A. C. Hayes, R. Lin and W. Clarke
The efficacy of concomitant lumbar sympathectomy in improving results of
aortoiliac reconstruction was assessed by a prospective, randomized study
of 51 patients undergoing operation for occlusive or aneurysmal disease.
Sympathectomy was performed on 50 limbs, while 52 extremities served as
controls. Sympathectomy resulted in a significant reduction in foot
vascular resistance determined by plethysmography. However, the procedure
had no effect on leg circulation, assessed by ankle/arm pressure indices
determined by Doppler ultrasound. In the sympathectomy group, there were
three early postoperative amputations for ischemia, despite patent grafts.
In the control group, there was one late graft occlusion, caused by
progressive atherosclerotic disease. Although sympathectomy may improve
pedal circulation, the procedure does not appear to improve the results of
aortoiliac reconstruction.
