[Clinical results of lumbar sympathectomy as a function of the amplification factor of Hillestad's reactive hyperemia test. Apropos of a series of 72 cases of isolated lumbar sympathectomies].

The efficacy of isolated lumbar sympathectomy was studied in 72 patients (36 with claudication, 36 with permanent ischemia) as a function of results of Hillestad's reactive hyperemia test (R.H.T.). Results were also assessed as a function of glucose tolerance, of the stage in Leriche and Fontaine's classification, of angiographic data, of certain pre-operative vascular function exploratory test parameters: systolic index at the ankle, digital pulsatility, segmental impedance plethysmography (irrigraphy), the tibial artery score and particularly the value for R.H.T. in the lower limb contralateral to the one for which sympathectomy was performed. Good results are very probable when the R.H.T. is positive or indifferent only in the lower limb for which sympathectomy is performed. Results were in fact better as the R.H.T. became more positive. Failure of treatment is very probable when the R.H.T. is indifferent in both lower limbs, particularly when the limb involved has an ankle systolic pressure lower than 0.25, an irrigraphic index lower than 0.10, the digital pulsatility has disappeared and the tibial artery score is 2/6 or less.