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Effect of Lumbar Sympathectomy in Distal Arterial Obstruction

Effect of Lumbar Sympathectomy in Distal Arterial Obstruction Abstract • We developed a model that simulates distal arterial occlusive disease to determine the effects of sympathectomy on certain hemodynamic changes. Two groups of seven dogs each received unilateral distal popliteal artery ligation. intraarterial BPs, angiography, pulse volume recordings (PVRs), and photoplethysmograms were taken of the distal hind limb throughout the experiment. After ligation, PVR and distal hind limb pressures were lowered to less than half of the preligation values. Four days after unilateral distal popliteal artery ligation, group 2 dogs received lumbar sympathectomy on the same side as the ligation. One week after sympathectomy, the PVR amplitudes and pressures showed a transient significant rise. Two weeks after sympathectomy, the PVR pressures and amplitudes returned to the previous, diminished postligation values. (Arch Surg 1983;118:1157-1160) References 1. Rutherford RB, Valenta J: Extremity blood flow and distribution: The effects of arterial occlusion, sympathectomy, and exercise . Surgery 1971;69: 332. 2. Moore WS, Hall AD: Effects of lumbar sympathectomy on skin capillary blood flow in arterial occlusive disease . J Surg Res 1973;14:151.Crossref 3. Lee BY, Trainor FS, Kavner D, et al: Management of severe ischemia of the foot secondary to occlusive vascular disease . Surg Gynecol Obstet 1979;148:233. 4. Lee BY, Trainor FS, Kavner D, et al: Assessment of the healing potentials of ulcers of the skin by photoplethysmography . Surg Gynecol Obstet 1979;148:233. 5. Weissenhofer W, Schenk WG: Effects of sympathectomy on blood flow through stenotic vessels during exercise: An experimental study in a canine model . Surgery 1973;74:734. 6. Rogers W, Reller CR, Sheridan JD, et al: Tissue blood flow in the canine lower limb following lumbar sympathectomy . Vase Surg 1972;6:227.Crossref 7. May AG, DeWeese JA, Rob CG: Effect of sympathectomy on blood flow in arterial stenosis . Ann Surg 1963;158:182.Crossref 8. Kreuzer W, Shenk WG: Hemodynamic responses to lumbar sympathectomy . J Cardiovasc Surg 1979;12:532. 9. Cronenwett JL, Lindenauer SM: Direct measurementof arteriovenous anastomotic blood flow after lumbar sympathectomy . Surgery 1977;82:82. 10. Cronenwett JL, Lindenauer SM: Hemodynamic effects of sympathectomy in ischemic canine hindlimbs . Surgery 1980;87:417. 11. Carr JJ, Crooks JA, Griffiths PA, et al: Capillary blood flow in ischemic limbs before and after surgery assessed by subcuticular injection of Xenon133 . Am J Surg 1977;133:584.Crossref 12. Davis MT, Greene NM: Polarographic studies of skin oxygen tension following sympathetic denervation . J Appi Physiol 1959;14:961. 13. Uhrenholdt A, Dan WH, Larsen OA, et al: Paradoxical effects on peripheral blood flow after sympathetic blockades in patients with gangrene due to arteriosclerosis obliterans . Vase Surg 1971;5:154.Crossref 14. Fulton RL, Blakeley WR: Lumbar sympathectomy: A procedure of questionable value in the treatment of arteriosclerosis obliterans of the legs . Am J Surg 1968;115:5. 15. Haimovici H, Steinman C, Karson IH: Evaluation of lumbar sympathectomy . Arch Surg 1964;89:1081. 16. Collins GJ, Rich NM, Andersen CA, et al: Acute hemodynamic effects of lumbar sympathectomy . Am J Surg 1978;136:120.Crossref 17. Shanik G, Hayes A, Barnes RW: Foot vascular index: A non-invasive method to assess foot vasomotor tone . Surgery 1975;78:446. 18. Stevenson IM, Walse PN, Santer GJ: Extended deep femoral angioplasty and lumbar sympathectomy as a limb salvage procedure . Ann R Coll Surg Engl 1979;61:146. 19. Plecha FR, Bomberger RA, Hoffman M, et al: A new criteria for predicting response to lumbar sympathectomy in patients with severe arteriosclerotic occlusive disease . Surgery 1980;88:375. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Effect of Lumbar Sympathectomy in Distal Arterial Obstruction

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References (23)

Publisher
American Medical Association
Copyright
Copyright © 1983 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1983.01390100031008
Publisher site
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Abstract

Abstract • We developed a model that simulates distal arterial occlusive disease to determine the effects of sympathectomy on certain hemodynamic changes. Two groups of seven dogs each received unilateral distal popliteal artery ligation. intraarterial BPs, angiography, pulse volume recordings (PVRs), and photoplethysmograms were taken of the distal hind limb throughout the experiment. After ligation, PVR and distal hind limb pressures were lowered to less than half of the preligation values. Four days after unilateral distal popliteal artery ligation, group 2 dogs received lumbar sympathectomy on the same side as the ligation. One week after sympathectomy, the PVR amplitudes and pressures showed a transient significant rise. Two weeks after sympathectomy, the PVR pressures and amplitudes returned to the previous, diminished postligation values. (Arch Surg 1983;118:1157-1160) References 1. Rutherford RB, Valenta J: Extremity blood flow and distribution: The effects of arterial occlusion, sympathectomy, and exercise . Surgery 1971;69: 332. 2. Moore WS, Hall AD: Effects of lumbar sympathectomy on skin capillary blood flow in arterial occlusive disease . J Surg Res 1973;14:151.Crossref 3. Lee BY, Trainor FS, Kavner D, et al: Management of severe ischemia of the foot secondary to occlusive vascular disease . Surg Gynecol Obstet 1979;148:233. 4. Lee BY, Trainor FS, Kavner D, et al: Assessment of the healing potentials of ulcers of the skin by photoplethysmography . Surg Gynecol Obstet 1979;148:233. 5. Weissenhofer W, Schenk WG: Effects of sympathectomy on blood flow through stenotic vessels during exercise: An experimental study in a canine model . Surgery 1973;74:734. 6. Rogers W, Reller CR, Sheridan JD, et al: Tissue blood flow in the canine lower limb following lumbar sympathectomy . Vase Surg 1972;6:227.Crossref 7. May AG, DeWeese JA, Rob CG: Effect of sympathectomy on blood flow in arterial stenosis . Ann Surg 1963;158:182.Crossref 8. Kreuzer W, Shenk WG: Hemodynamic responses to lumbar sympathectomy . J Cardiovasc Surg 1979;12:532. 9. Cronenwett JL, Lindenauer SM: Direct measurementof arteriovenous anastomotic blood flow after lumbar sympathectomy . Surgery 1977;82:82. 10. Cronenwett JL, Lindenauer SM: Hemodynamic effects of sympathectomy in ischemic canine hindlimbs . Surgery 1980;87:417. 11. Carr JJ, Crooks JA, Griffiths PA, et al: Capillary blood flow in ischemic limbs before and after surgery assessed by subcuticular injection of Xenon133 . Am J Surg 1977;133:584.Crossref 12. Davis MT, Greene NM: Polarographic studies of skin oxygen tension following sympathetic denervation . J Appi Physiol 1959;14:961. 13. Uhrenholdt A, Dan WH, Larsen OA, et al: Paradoxical effects on peripheral blood flow after sympathetic blockades in patients with gangrene due to arteriosclerosis obliterans . Vase Surg 1971;5:154.Crossref 14. Fulton RL, Blakeley WR: Lumbar sympathectomy: A procedure of questionable value in the treatment of arteriosclerosis obliterans of the legs . Am J Surg 1968;115:5. 15. Haimovici H, Steinman C, Karson IH: Evaluation of lumbar sympathectomy . Arch Surg 1964;89:1081. 16. Collins GJ, Rich NM, Andersen CA, et al: Acute hemodynamic effects of lumbar sympathectomy . Am J Surg 1978;136:120.Crossref 17. Shanik G, Hayes A, Barnes RW: Foot vascular index: A non-invasive method to assess foot vasomotor tone . Surgery 1975;78:446. 18. Stevenson IM, Walse PN, Santer GJ: Extended deep femoral angioplasty and lumbar sympathectomy as a limb salvage procedure . Ann R Coll Surg Engl 1979;61:146. 19. Plecha FR, Bomberger RA, Hoffman M, et al: A new criteria for predicting response to lumbar sympathectomy in patients with severe arteriosclerotic occlusive disease . Surgery 1980;88:375.

Journal

Archives of Surgery – American Medical Association

Published: Oct 1, 1983

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