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Lumbar Sympathetic Neurolysis: How to and When to Use? Tech Vasc Interv Radiol 2016 Jun;19(2):163-8

Date

07/18/2016

Pubmed ID

27423998

DOI

10.1053/j.tvir.2016.04.008

Scopus ID

2-s2.0-84969504531 (requires institutional sign-in at Scopus site)   19 Citations

Abstract

Lumbar sympathectomy was historically a mainstay of treatment for arterial occlusive disease and other vasospastic disorders, before the development of contemporary arterial reconstructive procedures either by surgical or endovascular means. Today, percutaneous methods of sympathetic blockade are possible using chemical neurolytic or ablative modalities. Lumbar sympathetic neurolysis is generally reserved for those patients with ischemic rest pain in the setting of nonreconstructable arterial occlusive disease, although patients with complex regional pain syndrome, peripheral neuralgia, vasospastic disorders, and various other disease states such as plantar hyperhydrosis may also benefit. A working knowledge of procedural anatomy and physiology, accompanied by appropriate patient selection, serve to maximize procedural success and minimize complications, which although infrequent may cause significant morbidity. A review of technique with a focus on traditional fluoroscopy is described, with attention drawn to intraprocedural and immediate postprocedural findings, as well as discussion of expected outcomes.

Author List

Zechlinski JJ, Hieb RA

Author

Robert A. Hieb MD, RVT, FSIR Professor in the Radiology department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Ethanol
Ganglia, Sympathetic
Humans
Ischemia
Lower Extremity
Lumbar Vertebrae
Peripheral Arterial Disease
Sympathectomy, Chemical
Treatment Outcome