VINTAGE TECHNIQUE IN VASCULAR SURGERY: LUMBAR SYMPATHECTOMY IN CRITICAL LIMB ISCHEMIA

• Autor(a) principal: Durán Mariño, José Luis
• Data de Publicação: 2021
• Outros Autores: Martínez Gallego, Eva Lucía, Pérez Carballo, Eva, Rielo Arias, Francisco Xavier, Pena Holguín, Juan, Velásquez Castañeda, Laura
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://doi.org/10.48750/acv.394
• topic: Critical limb ischemia; Buerguer's disease; Lumbar sympathectomy; Isquemia crítica de membro; Doença de Buerguer; Simpatectomia lombar

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.