SOME LIMITATIONS OF LUMBAR SYMPATHECTOMY IN ARTERIOSCLEROSIS OBLITERANS

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Abstract
GENERALLY favorable comments have recently been made concerning the use of lumbar sympathectomy in the treatment of arteriosclerosis obliterans. Improvement following this procedure has been thought to be (1) dependent on elimination of the vasospastic factor; (2) an increase in collateral circulation, and, perhaps, (3) a decrease in response to certain detrimental environmental factors such as exposure to cold. The degree and duration of the benefits which may be expected from lumbar sympathectomy in arteriosclerosis obliterans and reliable criteria for the selection of cases have not yet been fully determined. Although many surgeons suggest that little is to be lost, even in severe cases, a too enthusiastic attitude may, in time, bring discredit on a procedure which will certainly salvage many properly selected extremities. For this reason, the following represents an analysis of 100 consecutive lumbar sympathectomies for severe arteriosclerosis in an effort to determine which patients, if any, have

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