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November 1977

Value of Concomitant Sympathectomy in Aortoiliac Reconstruction: Results of a Prospective, Randomized Study

Author Affiliations

From the Departments of Surgery (Drs Barnes, Baker, and Shanik, Mr Maixner, and Mr Hayes) and Preventive Medicine (Dr Clarke and Mr Lin), University of Iowa Hospitals and Veterans Administration Hospital, Iowa City. Dr Barnes is currently with the Medical College of Virginia Commonwealth University, Richmond, and Dr Baker is currently with Loyola University School of Medicine, Maywood, Ill.

Arch Surg. 1977;112(11):1325-1330. doi:10.1001/archsurg.1977.01370110059006

• The efficacy of concomitant lumbar sympathectomy in improving results of aortoiliac reconstruction was assessed by a prospective, randomized study of 51 patients undergoing operation for occlusive or aneurysmal disease. Sympathectomy was performed on 50 limbs, while 52 extremities served as controls. Sympathectomy resulted in a significant reduction in foot vascular resistance determined by plethysmography. However, the procedure had no effect on leg circulation, assessed by ankle/arm pressure indices determined by Doppler ultrasound. In the sympathectomy group, there were three early postoperative amputations for ischemia, despite patent grafts. In the control group, there was one late graft occlusion, caused by progressive atherosclerotic disease. Although sympathectomy may improve pedal circulation, the procedure does not appear to improve the results of aortoiliac reconstruction.

(Arch Surg 112:1325-1330, 1977)

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