The early use of operative lumbar sympathectomy in peripheral vascular disease.

The results of operative lumbar sympathectomy for both intermittent claudication and rest pain in 153 patients have been reviewed. Sympathectomy was performed as an initial procedure to further below the groin reconstructive surgery, should symptoms not be alleviated. Five year post-sympathectomy, 67% of the claudicant and 54% of the rest pain patients had avoided further surgery. Patient mortality from other manifestations of atherosclerosis was notably poor at five years and was significantly greater than the sympathectomy failure rate after the first year. The results in diabetics were not significantly different from those in non-diabetics. The possible value of lumbar sympathectomy in both claudication and rest pain is reviewed and discussed.