Value of Concomitant Sympathectomy in Aortoiliac Reconstruction

Barnes, Robert W.; Baker, William H.; Shanik, Gregor D.; Maixner, William; Hayes, Andrew C.; Lin, Richard J.; Clarke, William R.

doi:10.1001/archsurg.1977.01370110059006

Cited by 30 publications

(8 citation statements)

References 21 publications

(2 reference statements)

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“…Randomized controlled trials that show no beneficial effects on sympathectomy pain relief are present, [12][13][14] also there are studies showing that ulcer healing, pain relief and decrease in major amputation rates. [15][16][17] Although the effects of sympathectomy are not consistent, it is applied in selected cases because there are studies reporting positive results on ulcer healing, pain regression and amputation prevention.…”

Section: Discussionmentioning

confidence: 99%

Spinal cord stimulator for the treatment of ischemic pain-Burger’s Disease and Raynaud’s Disease: A report of 2 cases and literature review

Ertilav¹

2020

Agri

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İskemik ağrı, ekstremitelere yetersiz kan akımıyla sonuçlanan bir grup hastalığın ana semptomudur. Bu semptomatolojide iki ana hastalık ayırt edilir: kritik vasküler hastalık ve Raynaud fenomeni. Kritik vasküler hastalık diabetes mellitus veya hipertansiyonun neden olduğu aterosklerozun zemininde gelişmektedir. Raynaud fenomeni primer ve sekonder forma ayrılır. Primer form vazospazmdan nedenlidir ve altta yatan bir neden yoktur. İkincil form, altta yatan bağ dokusu veya romatizmal hastalıklar, tromboangit obliterans (Burger hastalığı) gibi periferal vasküler hastalıklar ile ilişkilidir. Raynaud hastalığında klinik bulgular, soğuğa maruz kalma ile morarma, soğukluk, ağrılı parestezi gibi vasomotor değişiklikler ve kronik iskemiden kaynaklanan ülserlerdir. Kritik iskemik hastalıkta klinik prezentasyon, erken evre için intermitten kladikasyo ve ileri evrelerde istirahat ağrısı, kangren, nekroz ve trofik değişiklikler de eklenir. Raynaud hastalığının erken evrede tedavisi medikal ve konservatiftir. İleri evre iskemik vasküler hastalık, tıbbi tedaviye dirençli ağrı, endovasküler tedaviye yetersiz yanıt, inoperabl vakalar gibi durumlarda sempatektomi ve spinal cord stimülasyonu (SKS) gibi girişimler uygulanabilir. SKS vazodilatör mediatörler ile vasküler rezistansı azaltır ve kan akımınıı arttırır. SKS ayrıca sempatik vazokonstriksiyonu baskılar, doku kanlanmasını arttırır, doku hasarını azaltır, ülser iyileşmesini sağlar ve ağrıyı azaltır. Bu olgu bildirimlerinde dirençli Raynaud hastalığının ve ileri evre Burger hastalığının SKS ile başarılı bir şekilde tedavi edildiğini gösterdik.

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Section: Discussionmentioning

confidence: 99%

Spinal cord stimulator for the treatment of ischemic pain-Burger’s Disease and Raynaud’s Disease: A report of 2 cases and literature review

Ertilav¹

2020

Agri

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“…A prospective controlled randomised clinical trial of chemical lumbar sympathectomy has shown that phenol has no role in the treatment of intermittent claudication (5). Clinical trials of operative lumbar sympathectomy with reconstruction have been done (1,13), but their failure to result in any improvement in graft patency throws doubt on the effect of chemical sympathectomy in such cases. The role of chemical lumbar sympathectomy in the treatment of diabetic feet is not clear.…”

Section: Discussionmentioning

confidence: 99%

Chemical lumbar sympathectomy revisited: survey of the current practice of vascular surgeons in Scotland

2003

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“…Only Cross and Cotton 12 found significant pain reduction in the group treated with chemical lumbar sympathectomy compared to the control group (bupivacaine injection) (66.7% vs. 23.5%), but no changes in the ankle‐brachial index. The two other randomized controlled trials (RCTs) did not show any objective advantages 13,14 …”

Section: Treatment Optionsmentioning

confidence: 98%

25. Ischemic Pain in the Extremities and Raynaud’s Phenomenon

Devulder,

van Suijlekom,

van Dongen

et al. 2011

Pain Practice

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Two important groups of disorders result from an insufficient blood supply to the extremities: critical vascular disease and the Raynaud's phenomenon. The latter can be subdivided into a primary and a secondary type. Critical ischemic disease is often caused by arteriosclerosis due to hypertension or diabetes. Primary Raynaud's is idiopathic and will be diagnosed as such if underlying systemic pathology has been excluded. Secondary Raynaud's is often a manifestation of a systemic disease. It is essential to try to establish a diagnosis as soon as possible in order to influence the evolution of the disease. A sympathetic nerve block can be considered in patients with critical ischemic vascular disease after extensive conservative treatment, preferably in the context of a study (2B±). If this has insufficient effect, spinal cord stimulation can be considered in a selected patient group (2B±). In view of the degree of invasiveness and the costs involved, this treatment should preferably be applied in the context of a study and with the use of transcutaneous pO(2) measurements. In case of primary Raynaud's, life style changes are the first step. Sympathectomy can be considered as a treatment of Raynaud's phenomenon (2C+), but only after multidisciplinary evaluation of the patient and in close consultation with the patient's rheumatologist, vascular surgeon or internist.

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Value of Concomitant Sympathectomy in Aortoiliac Reconstruction

Cited by 30 publications

References 21 publications

Spinal cord stimulator for the treatment of ischemic pain-Burger’s Disease and Raynaud’s Disease: A report of 2 cases and literature review

Spinal cord stimulator for the treatment of ischemic pain-Burger’s Disease and Raynaud’s Disease: A report of 2 cases and literature review

Chemical lumbar sympathectomy revisited: survey of the current practice of vascular surgeons in Scotland

25. Ischemic Pain in the Extremities and Raynaud’s Phenomenon

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