Jesús Ruiz-Aragón1, Soledad Márquez Calderón. 1. Agencia de Evaluación de Tecnologías Sanitarias de Andalucía , Consejería de Salud de la Junta de Andalucía, Sevilla, España. jesusm.ruiz.ext@juntadeandalucia.es
Abstract
BACKGROUND AND OBJECTIVES: The aim of this work has been to check the scientific evidence on the efficacy of lumbar sympathectomy in the treatment of peripheral arterial disease of lower limbs. MATERIAL AND METHODS: Systematic review of the literature. DATA SOURCE: MedLine, Embase, Cochrane Library, INHATA, CRD, BioMed Central, and ClinicalTrials.gov register. Mesh terms: sympathectomy, peripheral vascular disease, lower extremity, vascular therapy, iliac artery, femoral artery, popliteal artery. INCLUSION CRITERIA: adult patients with occlusive peripheral arterial disease of lower limbs treated with sympathectomy. The quality was evaluated by means of the criteria of the CASP checklist and "ad hoc" questionnaire. RESULTS: Four clinical trials and four observational studies were included. Sympathectomy did not show significant differences for mortality, amputations and grade of intermittent claudication. When it was assessed regarding local anaesthetics or prostaglandin-E1, differences were not detected. Chemical sympathectomy showed better results than surgical sympathectomy in hospital stance. CONCLUSIONS: Evidence on the efficacy of sympathectomy does not show differences related to conventional treatments. Both sympathectomy techniques (surgical and chemical) do not report statistical differences regarding mortality or amputations.
BACKGROUND AND OBJECTIVES: The aim of this work has been to check the scientific evidence on the efficacy of lumbar sympathectomy in the treatment of peripheral arterial disease of lower limbs. MATERIAL AND METHODS: Systematic review of the literature. DATA SOURCE: MedLine, Embase, Cochrane Library, INHATA, CRD, BioMed Central, and ClinicalTrials.gov register. Mesh terms: sympathectomy, peripheral vascular disease, lower extremity, vascular therapy, iliac artery, femoral artery, popliteal artery. INCLUSION CRITERIA: adult patients with occlusive peripheral arterial disease of lower limbs treated with sympathectomy. The quality was evaluated by means of the criteria of the CASP checklist and "ad hoc" questionnaire. RESULTS: Four clinical trials and four observational studies were included. Sympathectomy did not show significant differences for mortality, amputations and grade of intermittent claudication. When it was assessed regarding local anaesthetics or prostaglandin-E1, differences were not detected. Chemical sympathectomy showed better results than surgical sympathectomy in hospital stance. CONCLUSIONS: Evidence on the efficacy of sympathectomy does not show differences related to conventional treatments. Both sympathectomy techniques (surgical and chemical) do not report statistical differences regarding mortality or amputations.