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Type: Journal article
Title: Computed tomography fluoroscopy-guided chemical lumbar sympathectomy: Simple, safe and effective
Author: Tay, V.
Fitridge, R.
Tie, M.
Citation: Journal of Medical Imaging and Radiation Oncology, 2002; 46(2):163-166
Publisher: Blackwell Science Asia Pty Ltd
Issue Date: 2002
ISSN: 0004-8461
Statement of
Victoria K.M. Tay, Robert Fitridge and Mark L.H. Tie
Abstract: Demographic, clinical and laboratory data were retrospectively collected from records of 146 cases of CT fluoroscopy-guided chemical lumbar sympathectomy for the palliation of inoperable peripheral vascular disease (PVD) between January 1997 and August 1999. Of these, 16% had claudication, 39% had rest pain and 44% had ischaemic ulcers or gangrene. Seventy-three percent of elective cases were outpatients. At 3 months, 27 cases were lost to follow up, leaving 119 cases. Within 3 months, improvement, defined as doubling of the walking distance, cessation of rest pain or healing of ulcers, occurred in 30.3% of cases. No change was observed in 45.4% of cases and 24.3% of cases deteriorated. Patients with ulcers or gangrene had significantly poorer results than those without any ischaemic lesions, as only 19% versus 39% of patients improved (P < 0.05). The presence of hypertension, diabetes mellitus, hyperlipidaemia and smoking had no value in predicting clinical outcome (P > 0.05). There were no major complications noted. CT fluoroscopy-guided chemical lumbar sympathectomy is safe and effective, with a complication rate of less than 1%, and efficacy of at least 30% measured within 3 months. It is a simple and minimally invasive procedure, easily performed on an outpatient basis. CT fluoroscopy-guided chemical lumbar sympathectomy should be considered for all patients in the early stages of inoperable PVD.
Keywords: Peripheral vascular disease
Computed-tomography guidance
Interventional procedures
Lumbar sympathectomy
Description: The definitive version is available at
DOI: 10.1046/j.1440-1673.2001.01027.x
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