Preoperative selection of patients for lumbar sympathectomy by use of the Doppler index.
Yao and Bergan [8] have shown that an ankle systolic index of more than 0.25 is associated with a high rate of success from lumbar sympathectomy. This association has been borne out in our small series. We have also suggested that diseases that obviously compromise collateral circulation might be a relative contraindication to sympathectomy. Although incomplete, literature on collateral flow in relation to sympathectomy tends to confirm this idea. Consideration of such diseases as a contraindication to sympathectomy might further increase the success rate after sympathectomy. Regardless, ankle systolic index alone appears to be a reliable objective, non-invasive method of selecting patients with an increased chance of success from lumbar sympathectomy.
D000328:Adult; D000368:Aged; D000671:Amputation, Surgical; D001794:Blood Pressure; D003097:Collateral Circulation; D005734:Gangrene / Q000601:surgery*; D006801:Humans; D007383:Intermittent Claudication / Q000601:surgery*; D007871:Leg Ulcer / Q000601:surgery*; D008161:Lumbosacral Region; D008297:Male; D008875:Middle Aged; D059408:Pain Management; D013562:Sympathectomy; D014034:Toes; D014463:Ultrasonography