Vayssairat M, Gouny P, Baudot N, Gaitz J P, Nussaume O
Service de Chirurgie vasculaire, Hôpital Rothschild, Paris.
J Mal Vasc. 1994;19 Suppl A:174-7.
Among atheromatous occlusive arterial disease of the lower limbs, chronic sub-popliteal arterial occlusions refer an heterogenous group of patients. In this medical condition, lumbar sympathectomy constitutes a classical possible treatment. Actually, the beneficial effect of sympathectomy has never been confirmed by controlled randomised trials. In this particular and uncomfortable situation, it is only possible to list non indications for sympathectomy: asymptomatic patient, claudication, critical ischemia, limb salvage, and combination with vascular surgery. Lumbar sympathectomy deserves a controlled evaluation in patients with a small foot ischemic ulceration without hemodynamic critical ischemia i.e. systolic toe pressure > 30 mm Hg and/or ankle systolic pressure > 50 mm Hg.
在下肢动脉粥样硬化闭塞性疾病中，慢性腘动脉以下动脉闭塞涉及一组异质性患者。在这种病症中，腰交感神经切除术是一种经典的可能治疗方法。实际上，交感神经切除术的有益效果从未得到对照随机试验的证实。在这种特殊且令人不适的情况下，只能列出交感神经切除术的非适应证：无症状患者、间歇性跛行、严重缺血、肢体挽救以及与血管手术联合使用。对于足部有小缺血性溃疡且无血流动力学严重缺血（即趾收缩压>30 mmHg和/或踝部收缩压>50 mmHg）的患者，腰交感神经切除术值得进行对照评估。
