Lumbar sympatectomy in critical limb ischaemia: surgical, chemical or not at all?
| Autor: | F.A.C. Holiday, R. Slappendel, B.J.P. Crul, W.B. Barendregt, F.G.M. Buskens, J.A. van der Vliet |
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| Rok vydání: | 1999 |
| Předmět: |
musculoskeletal diseases
Male medicine.medical_specialty medicine.medical_treatment Lumbosacral Plexus Ischemia Arterial Occlusive Diseases Quantification of effects of anesthesia Lumbar sympathectomy Impaired oxygen extraction in reperfusion injury medicine Humans Radiology Nuclear Medicine and imaging Stage (cooking) Sympathectomy Gestoorde zuurstofextractie bij het reperfusiesyndroom Kwantificeren van anesthesie-effecten Leg business.industry Critical limb ischaemia Sympathectomy Chemical Middle Aged medicine.disease Surgery Lumbosacral plexus Treatment Outcome Concomitant Anesthesia Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Cardiovascular Surgery, 7, pp. 200-202 Cardiovascular Surgery, 7, 200-202 |
| ISSN: | 0967-2109 |
| Popis: | The value of surgical and chemical lumbar sympathectomy was studied in patients with critical lower-limb ischaemia without the option of vascular reconstruction. Clinical success rates, defined as improvement of ischaemia stage, and limb salvage rates were recorded for 76 limbs of 70 consecutive patients. Chemical lumbar sympathectomy patients were older and had more concomitant diseases than surgical lumbar sympathectomy patients. The short-term (6-week) success rate in 36 cases treated with surgical lumbar sympathectomy (44%) was better than in 40 cases treated with chemical lumbar sympathectomy (18%) (P = 0.01). The long-term (1-year) success rate was 47% for surgical lumbar sympathectomy and 45% for chemical lumbar sympathectomy (P = NS). The 1-year limb salvage rates were 61% for surgical lumbar sympathectomy and 58% for chemical lumbar sympathectomy (P = NS). Complications were minor in both groups. Lumbar sympathectomy still has a limited role in the treatment of critical limb ischaemia in patients without the option of vascular reconstruction. Both surgical and chemical lumbar sympathectomy can be performed with very little morbidity and may provide a benefit over the natural course of the arterial insufficiency. |
| Databáze: | OpenAIRE |
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