[Are there indications for sympatholysis using phenol?].

A phenol injection of the lumbar sympathetic chain has been performed 45 times on 40 patients whose mean age was 78 years and whose poor general condition was a contra-indication to any kind of anesthesia. The results have been evaluated at one month and one year in 33 patients. Among these patients, 21 had an available distal artery seen on the arteriography and 12 no distal artery. Our results suggest that: the injection is not always easy, the rate of complications is important: 2 deaths (4.5%) and 4 serious complications (9%) mainly nervous irritations, the rate of good results is poor: 42% at one month and 27% at one year. When there is a toe gangrene without any distal artery, a good result should not be expected. The diabetes mellitus had no incidence on our results. The indications to a phenol lumbar sympathectomy have to be selected: the best results have been obtained on patients with rest pain or ischemic ulcers when at least a distal artery could be visualized on arteriography. On the other hand no good result should be expected when there is a toe gangrene or when there is no distal flow either on the arteriography or on Doppler examination.