Publicação
Vintage Technique in Vascular Surgery: Lumbar sympathectomy in critical limb ischemia.
| Resumo: | Abstract 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. |
|---|---|
| Autores principais: | Mariño,José Luis Durán |
| Outros Autores: | Gallego,Eva Lucía Martínez; Carballo,Eva Pérez; Arias,Francisco Javier Rielo; Holguín,Juan Pena; Castañeda,Laura Velásquez |
| Assunto: | Critical limb ischemia Buerguer's disease Lumbar sympathectomy |
| Ano: | 2021 |
| País: | Portugal |
| Tipo de documento: | relatório |
| Tipo de acesso: | acesso aberto |
| Instituição associada: | Fundação para a Ciência e Tecnologia |
| Idioma: | inglês |
| Origem: | SciELO Portugal |
| Resumo: | Abstract 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. |
|---|