Lumbar chemical sympathectomy in peripheral vascular disease: Does it still have a role?
| Autor: | Barry J. Nichols, Paul S. Eyers, M.K. Ajit, Prabhu Nesargikar, John F. Chester |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
medicine.medical_specialty
Peripheral vascular disease (PVD) Ischemia Surveys and Questionnaires medicine Humans Peripheral Vascular Diseases Lumbar Vertebrae integumentary system business.industry Vascular disease Sympathectomy Chemical Ischemic rest pain General Medicine medicine.disease United Kingdom Peripheral Outcome parameter Surgery Lumbar chemical sympathectomy (LCS) Lower Extremity Current practice Lumbar chemical sympathectomy Neuralgia UK and Irish vascular surgical practice business Paraplegia |
| Zdroj: | International Journal of Surgery. 7(2):145-149 |
| ISSN: | 1743-9191 |
| DOI: | 10.1016/j.ijsu.2009.01.004 |
| Popis: | Introduction Lumbar chemical sympathectomy (LCS) is used principally in inoperable peripheral vascular disease (PVD) to alleviate symptoms of rest pain and as an adjunct to other treatments for ulcers. No guidelines currently exist in the UK for its use in PVD. The aim of this study was to evaluate the role of LCS with regard to indications and outcomes in the UK and Irish vascular surgical practice. Methods Specifically designed questionnaires were sent to Vascular Surgical Society members. The questions related to their current use of LCS including indications, outcome parameters, use in diabetics and complications encountered. Results Four hundred and ninety postal questionnaires were sent out and 242 responses (49%) were received. Seventy five percent of the respondents ( n =183) felt that LCS had a role in current practice. Seventy eight percent ( n =144) performed less than 10 procedures per year and 3% ( n =5) more than 20 per year. Eighty percent ( n =145) were performed by anaesthetists, 12% ( n =23) by radiologists and 8% ( n =15) by surgeons. Inoperable peripheral vascular disease with rest pain was the main indication in over 80% of responses with 27% using it for the treatment of ulcers. Only 21% used LCS in diabetics. Clinical improvement was used to assess the outcome following LCS in 96% of responses. Complications included neuralgia, ureteric damage and paraplegia following inadvertent extradural injection. Conclusion Although no clear guidance exists for the use of LCS in PVD, the majority of respondents continue to use it. Indications and outcomes are documented in this study of UK and Irish vascular surgical practice. |
| Databáze: | OpenAIRE |
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