<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1646-706X</journal-id>
<journal-title><![CDATA[Angiologia e Cirurgia Vascular]]></journal-title>
<abbrev-journal-title><![CDATA[Angiol Cir Vasc]]></abbrev-journal-title>
<issn>1646-706X</issn>
<publisher>
<publisher-name><![CDATA[Sociedade Portuguesa de Angiologia e Cirurgia Vascular]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1646-706X2021000100047</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Vintage Technique in Vascular Surgery: Lumbar sympathectomy in critical limb ischemia.]]></article-title>
<article-title xml:lang="pt"><![CDATA[Técnica Vintage em Cirurgia Vascular: Simpatectomia lombar na isquemia crítica de membro.]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Mariño]]></surname>
<given-names><![CDATA[José Luis Durán]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gallego]]></surname>
<given-names><![CDATA[Eva Lucía Martínez]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Carballo]]></surname>
<given-names><![CDATA[Eva Pérez]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Arias]]></surname>
<given-names><![CDATA[Francisco Javier Rielo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Holguín]]></surname>
<given-names><![CDATA[Juan Pena]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Castañeda]]></surname>
<given-names><![CDATA[Laura Velásquez]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Lucus Augusti Universitary Hospital Department of Vascular Surgery ]]></institution>
<addr-line><![CDATA[Lugo ]]></addr-line>
<country>Spain</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,IMED Levante Hospital Department of Vascular Surgery ]]></institution>
<addr-line><![CDATA[Benidorm ]]></addr-line>
<country>Spain</country>
</aff>
<pub-date pub-type="pub">
<day>30</day>
<month>03</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>30</day>
<month>03</month>
<year>2021</year>
</pub-date>
<volume>17</volume>
<numero>1</numero>
<fpage>47</fpage>
<lpage>50</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S1646-706X2021000100047&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S1646-706X2021000100047&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S1646-706X2021000100047&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction:  Tromboangiitis Obliterans or Buerguer&amp;apos;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&amp;apos;s more, direct surgery is also not possible.  Conclusions:  Lumbar sympathectomy can work not only in this scenary of Buerguer&amp;apos;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.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução:  A tromboangeíte Obliterante ou doença de Buerguer é uma das expressões da doença arterial periférica; a sua principal característica é a oclusão dos principais eixos arteriais distais, o que impede a cirurgia de revascularização direta; A simpatectomia lombar foi já utilizada para tratar essa condição com resultados aceitáveis, mas hoje em dia esta técnica é considerada obsoleta; muitos jovens cirurgiões vasculares nem mesmo ouviram falar e a maioria deles nunca viu uma simpatectomia lombar para o tratamento de doentes com isquemia crítica de membro.  Caso-clínico:  Mulher de 39 anos admitida com isquemia crítica de membro consequente à oclusão da artéria poplítea sem eixos distais permeáveis, tratada com a realização de uma simpatectomia lombar como técnica de recurso.  Discussão:  O tratamento endovascular é a primeira opção para a isquemia crítica de membro de causa aterosclerótica; embora a tromboangeíte obliterante seja menos frequente, ainda se observa nos dias de hoje, e é uma das situações em que o tratamento endovascular é ineficaz; além disso, a revascularização por cirurgia clássica, na maioria das vezes, também não é possível.  Conclusão:  A simpatectomia lombar pode ser eficaz, não apenas neste cenário da doença de Buerguer; pode ser usada como técnica de recurso quando a primeira abordagem pela cirurgia de revascularização falha e não há mais opções de salvamento do membro; assim, a simpatectomia lombar deve fazer parte do arsenal terapêutico de qualquer cirurgião vascular.]]></p></abstract>
<kwd-group>
<kwd lng="pt"><![CDATA[Isquemia crítica de membro]]></kwd>
<kwd lng="pt"><![CDATA[Doença de Buerguer]]></kwd>
<kwd lng="pt"><![CDATA[Simpatectomia lombar]]></kwd>
<kwd lng="en"><![CDATA[Critical limb ischemia]]></kwd>
<kwd lng="en"><![CDATA[Buerguer&amp;apos;s disease]]></kwd>
<kwd lng="en"><![CDATA[Lumbar sympathectomy]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Díez]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Le traitement de la thrombo-angéite oblitérante des membres infériours par la résection du sympathique lombaire (expérience basée sur 75 cas opérés et 6 années d&amp;apos;observations]]></article-title>
<source><![CDATA[Journal de Chirurgie]]></source>
<year>1931</year>
<volume>37</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>161-231</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Freeman]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[E , Leeds F.H., Gardner R.E. Sympathectomy for obliterative arterial disease. Indications and contraindications]]></article-title>
<source><![CDATA[Annals of Surgery]]></source>
<year>1947</year>
<volume>126</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>873-95</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Imparato]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[M Lumbar sympathectomy. Role in the treatment of occlusive arterial disease in the lower extremities]]></article-title>
<source><![CDATA[Surgical Clinics of North America]]></source>
<year>1979</year>
<volume>59</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>719-35</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Erichsen]]></surname>
<given-names><![CDATA[HG]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Lumbar sympathectomy in obliterative arteriosclerosis Should it still be performed?]]></article-title>
<source><![CDATA[Scand Cardiovasc J]]></source>
<year>1979</year>
<volume>13</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>333-7</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Dalessandri]]></surname>
<given-names><![CDATA[K.M.]]></given-names>
</name>
<name>
<surname><![CDATA[Carson]]></surname>
<given-names><![CDATA[S.N.]]></given-names>
</name>
<name>
<surname><![CDATA[Tillman]]></surname>
<given-names><![CDATA[P.]]></given-names>
</name>
<name>
<surname><![CDATA[Talken]]></surname>
<given-names><![CDATA[L.]]></given-names>
</name>
<name>
<surname><![CDATA[Wong]]></surname>
<given-names><![CDATA[H.N.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Effect of lumbar sympathectomy in distal arterial obstruction]]></article-title>
<source><![CDATA[Arch. Surg.]]></source>
<year>1983</year>
<volume>118</volume>
<page-range>1157-60</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[van der Stricht JP Effect of lumbar sympathectomy on the lower extremity]]></article-title>
<source><![CDATA[J Cardiovasc Surg (Torino)]]></source>
<year>1979</year>
<volume>20</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>301-11</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sanni]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Is sympathectomy of benefit in critical leg ischaemia not amenable to revascularisation]]></article-title>
<source><![CDATA[Interact Cardiovasc Thorac Surg]]></source>
<year>2005</year>
<volume>4</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>478-83</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fulton]]></surname>
<given-names><![CDATA[RL]]></given-names>
</name>
<name>
<surname><![CDATA[Blakeley]]></surname>
<given-names><![CDATA[WR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Lumbar sympathectomy A procedure of questionable value in the treatment of arteriosclerosis obliterans of the legs]]></article-title>
<source><![CDATA[Am J Surg]]></source>
<year>1968</year>
<volume>116</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>735-44</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gordon]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Zechmeister]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Collin]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The role of sympathectomy in current surgical practice]]></article-title>
<source><![CDATA[Eur J Vasc Surg]]></source>
<year>1994</year>
<volume>8</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>129-37</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Franco]]></surname>
<given-names><![CDATA[Pratesi]]></given-names>
</name>
</person-group>
<source><![CDATA[Microcirculazione e microangiologia. Edizione Minerva Médica (Torino)]]></source>
<year>1990</year>
<page-range>3-118</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Friedman]]></surname>
<given-names><![CDATA[SA]]></given-names>
</name>
<name>
<surname><![CDATA[Frieberg]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Colton]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Vasomotor tone in diabetic neuropathy]]></article-title>
<source><![CDATA[Ann. Intern Med]]></source>
<year>1972</year>
<volume>77</volume>
<page-range>353-5</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cid Dos Santos]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The diagnosis and treatment of vascular obstruction]]></article-title>
<source><![CDATA[Gaz Med Port]]></source>
<year>1948</year>
<volume>1</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>631-43</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Menzoian]]></surname>
<given-names><![CDATA[JO]]></given-names>
</name>
<name>
<surname><![CDATA[Koshar]]></surname>
<given-names><![CDATA[AL]]></given-names>
</name>
<name>
<surname><![CDATA[Rodrigues]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Alexis Carrel, Rene Leriche, Jean Kunlin, and the history of bypass surgery]]></article-title>
<source><![CDATA[J Vasc Surg]]></source>
<year>2011</year>
<volume>54</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>571-4</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Karanth]]></surname>
<given-names><![CDATA[VKL]]></given-names>
</name>
<name>
<surname><![CDATA[Karanth]]></surname>
<given-names><![CDATA[TK]]></given-names>
</name>
<name>
<surname><![CDATA[Karanth]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Lumbar sympathectomy techniques for critical lower limb ischaemia due to non-reconstructable peripheral arterial disease]]></article-title>
<source><![CDATA[Cochrane Database Syst Rev]]></source>
<year>2016</year>
<numero>12</numero>
<issue>12</issue>
</nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Qadura]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Terenzi]]></surname>
<given-names><![CDATA[DC]]></given-names>
</name>
<name>
<surname><![CDATA[Verma]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Al-Omran]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Hess]]></surname>
<given-names><![CDATA[DA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Concise Review Cell Therapy for Critical Limb Ischemia: An Integrated Review of Preclinical and Clinical Studies]]></article-title>
<source><![CDATA[Stem Cells]]></source>
<year>2018</year>
<volume>36</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>161-71</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
