INFRA-POPLITEAL ARTERIAL-OCCLUSION - LUMB AR SYMPATHECTOMY

Among atheromatous occlusive arterial disease of the lower limbs, chro nic sub-popliteal arterial occlusions refer an heterogenous group of p atients. In this medical condition, lumbar sympathectomy constitutes a classical possible treatment. Actually, the beneficial effect of symp athectomy has never been confirmed by controlled randomised trials. In this particular and uncomfortable situation, it is only possible to l ist non indications for sympathectomy: asymptomatic patient, claudicat ion, critical ischemia, limb salvage, and combination with vascular su rgery. Lumbar sympathectomy deserves a controlled evaluation in patien ts with a small foot ischemic ulceration without hemodynamic critical ischemia i.e. systolic toe pressure > 30 mm Hg and/or ankle systolic p ressure > 50 mm Hg.