[CT-guided sympathicolysis in peripheral artery disease - Indications, patient selection and long-term results].
OBJECTIVE
Assessment of long-term results of CT-guided lumbar sympathicolysis (LSL) in advanced peripheral arterial vascular disease (pavd). Establishment of a suitable patient selection.


METHODS
LSL was performed in 138 cases with Fontaine stages III (13 %) and IV (87 %). 250 consecutive patients were examined with a radionuclide perfusion study of the feet prior to and during peridural anaesthesia (PDA) in order to select suitable patients for LSL. LSL was not performed in patients with impaired perfusion under PDA (n = 112). Early and long-term results after one to five years were evaluated.


RESULTS
In 79 % an initial improvement was found after LSL. After more than one year success was established in 38 %. 49 % of the cases had a progression of the disease. This is significantly better compared to a control group with conservative treatment and an initial improvement of 36 %. After more than one year only12 % revealed an improvement. In 82 % the disease was progressive. Diabetics showed also a positive response to LSL.


CONCLUSIONS
LSL has a positive influence on the course of pvad in patients selected by radionuclide perfusion studies. Diabetes and angiographic findings do not play any first role in patient selection for LSL.
Huttner
S
S
Abteilung für Radiologie, Klinikum Kempten, Germany.
Huttner
M
M
Neher
M
M
Antes
G
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000767:Anesthesia, Epidural; D000779:Anesthetics, Local; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000628:therapy*; D000431:Ethanol; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D016491:Peripheral Vascular Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000628:therapy*; D011877:Radionuclide Imaging; D013563:Sympathectomy, Chemical; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000779:Anesthetics, Local; D000431:Ethanol