EFFECT OF SURGICAL SYMPATHECTOMY ON ARTERIAL BLOOD-FLOW IN REFLEX SYMPATHETIC DYSTROPHY - DOPPLER US ASSESSMENT

PURPOSE: To assess duplex Doppler ultrasound (US) in providing objecti ve, reproducible measurements of blood flow in patients with reflex sy mpathetic dystrophy (RSD) who underwent surgical sympathectomy. MATERI ALS AND METHODS: Findings in eight adult patients with RSD who were ev aluated with arterial duplex Doppler US after surgical sympathetectomy were retrospectively reviewed. Pulsatility index (PI) and waveform ch aracteristics were compared to clinical findings (temperature and sudo motor state) in sympathectomized limbs. RESULTS: Warm and dry limbs yi elded a consistently low PI (usually less than 2) and biphasic wavefor m. Cold and clammy limbs, which indicated failed sympathectomy, produc ed a high PI (usually greater than 4) and triphasic waveform. The Dopp ler waveform promptly reverted with the return of sympathetic tone in patients who had clinical relapse. CONCLUSION: Duplex Doppler US may b e useful for objective follow-up of RSD patients after sympathectomy.