Huttner S, Huttner M, Neher M, Antes G
Abteilung für Radiologie, Klinikum Kempten, Germany.
Rofo. 2002 Apr;174(4):480-4. doi: 10.1055/s-2002-25113.
Assessment of long-term results of CT-guided lumbar sympathicolysis (LSL) in advanced peripheral arterial vascular disease (pavd). Establishment of a suitable patient selection.
LSL was performed in 138 cases with Fontaine stages III (13 %) and IV (87 %). 250 consecutive patients were examined with a radionuclide perfusion study of the feet prior to and during peridural anaesthesia (PDA) in order to select suitable patients for LSL. LSL was not performed in patients with impaired perfusion under PDA (n = 112). Early and long-term results after one to five years were evaluated.
In 79 % an initial improvement was found after LSL. After more than one year success was established in 38 %. 49 % of the cases had a progression of the disease. This is significantly better compared to a control group with conservative treatment and an initial improvement of 36 %. After more than one year only12 % revealed an improvement. In 82 % the disease was progressive. Diabetics showed also a positive response to LSL.
LSL has a positive influence on the course of pvad in patients selected by radionuclide perfusion studies. Diabetes and angiographic findings do not play any first role in patient selection for LSL.
评估CT引导下腰交感神经切除术（LSL）治疗晚期周围动脉血管疾病（pavd）的长期效果。确定合适的患者选择标准。
对138例Fontaine III期（13%）和IV期（87%）的患者实施了LSL。对250例连续患者在硬膜外麻醉（PDA）前和期间进行足部放射性核素灌注研究，以选择适合LSL的患者。PDA时灌注受损的患者（n = 112）未进行LSL。评估了1至5年后的早期和长期结果。
79%的患者在LSL后最初有改善。一年多后，38%的患者取得了成功。49%的病例病情进展。这明显优于保守治疗的对照组，对照组最初改善率为36%。一年多后只有12%的患者病情有所改善。82%的患者病情进展。糖尿病患者对LSL也有阳性反应。
放射性核素灌注研究选择的患者中，LSL对pvad病程有积极影响。糖尿病和血管造影结果在LSL患者选择中不起首要作用。
