Foot vasomotor tone following aortofemoral and femoropopliteal reconstructions for limb ischaemia.

A foot arterial resistance index (FARI), determined plethysmographically, was used pre- and postoperatively to compare foot vasomotor tone following arterial reconstructions of the lower limb with and without the addition of lumbar sympathectomy. The index was measured before and during reactive hyperaemia in 40 patients without vascular disease; in 32 patients who underwent aortic reconstructions, 14 of whom were randomly subjected to a concomitant bilateral lumbar sympathectomy; and in 8 patients who had a femoropopliteal bypass for limb salvage. This study indicates that the addition of lumbar sympathectomy to aortic reconstructive operations enhances blood flow to the foot by significantly reducing foot vasomotor tone. Sympathectomy performed to reduce foot arterial resistance in patients undergoing successful femoropopliteal reconstructions may be of no benefit since a persistent marked postoperative hyperaemia of the foot is present.