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Angiologia e Cirurgia Vascular
Print version ISSN 1646-706X
Abstract
MARINO, José Luis Durán et al. Vintage Technique in Vascular Surgery: Lumbar sympathectomy in critical limb ischemia. Angiol Cir Vasc [online]. 2021, vol.17, n.1, pp.47-50. Epub Mar 31, 2021. ISSN 1646-706X.
Introduction:
Tromboangiitis Obliterans or Buerguer's disease is one of the expresions of the peripheral arterial disease; its main feauture is the absence of average distal outflow that precludes direct revascularization surgery; lumbar sympathectomy was carried out to treat this condition with acceptable results but nowadays this technique is described as obsolete; many young vascular surgeons have not even heard about it and most of them have never seen a lumbar sympathectomy for the treatment of patients with critical limb ischemia.
Case report:
A 39-year-old woman admitted with critical limb ischemia due to popliteal artery occlusion without average distal outflow, treated by a lumbar sympathectomy as a resource technique.
Discussion:
Today, endovascular treatment is the first option for the critical limb ischemia in most cases; althoug tromboangiitis obliterans is less frequent nowadays, exists, and this is one of the situations where endovascular treatment does not work; what's more, direct surgery is also not possible.
Conclusions:
Lumbar sympathectomy can work not only in this scenary of Buerguer's disease; it can be used as resource technique when the first approach with direct surgery has failed and there is not more options to limb salvage; thus, lumbar sympathectomy should be part of the therapeutic arsenal of any vascular surgeon.
Keywords : Critical limb ischemia; Buerguer's disease; Lumbar sympathectomy.