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LOW THORACIC-HIGH LUMBAR SYMPATHECTOMY FOR VASCULAR DISEASES OF THE LEGS

Robert P. Hohf

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Abstract

Sympathectomy in the treatment of vascular diseases of the lower extremities does not help as many patients as one would like. In 1950, one of us, (O. C. J.) and Shabart1reported improvement in 51% of 72 patients after the usual L-2-L-3 sympathectomy at this hospital. Although the number of favorable results has been reported to be as high as 93%,2most authors3find improvement in only one-half to three-fourths of the patients subjected to sympathectomy. Because the other patients usually require early amputation, it would be desirable to extend the benefits of the operation, if possible. Two avenues of approach to this problem are apparent. The first is the possibility of improving the absolute effect of the operation by some means such as excising the trunk to a higher level in the hope that opening collateral circulation more proximally might increase the blood supply to the

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What this paper is about

Sympathectomy in the treatment of vascular diseases of the lower extremities does not help as many patients as one would like. In 1950, one of us, (O. C. J.) and Shabart1reported improvement in 51% of 72 patients after the usual L-2-L-3 sympathectomy at this hospital. Although the number of favorable results has been reported to be as high as 93%,2most authors3find improvement in only one-half to three-fourths of the patients subjected to sympathectomy. Because the other patients usually require early amputation, it would be desirable to extend the benefits of the operation, if possible. Two avenues of approach to this problem are apparent. The first is the possibility of improving the absolute effect of the operation by some means such as excising the trunk to a higher level in the hope that opening collateral circulation more proximally might increase the blood supply to the

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Available abstract

Sympathectomy in the treatment of vascular diseases of the lower extremities does not help as many patients as one would like. In 1950, one of us, (O. C. J.) and Shabart1reported improvement in 51% of 72 patients after the usual L-2-L-3 sympathectomy at this hospital. Although the number of favorable results has been reported to be as high as 93%,2most authors3find improvement in only one-half to three-fourths of the patients subjected to sympathectomy. Because the other patients usually require early amputation, it would be desirable to extend the benefits of the operation, if possible. Two avenues of approach to this problem are apparent. The first is the possibility of improving the absolute effect of the operation by some means such as excising the trunk to a higher level in the hope that opening collateral circulation more proximally might increase the blood supply to the

Key concepts: Sympathectomy, Lumbar sympathectomy, Medicine, Amputation, Blood circulation, Trunk, Collateral circulation, Sympathetic trunk

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