Lumbar sympathectomy.

Lumbar sympathectomy is used in patients with threatened or early gangrene of the toes where reconstructive arterial surgery is not possible--usually because arteriography has demonstrated absence of a "run off" suitable for endarteriectomy or a bypass graft. It may also be a supplement to reconstructive surgery of the aorta or the common iliac arteries. It is indicated in intractable Raynaud's disease affecting the feet and is particularly helpful in severe hyperhidrosis of the feet. In many cases the procedure can be performed nonoperatively by chemical sympathectomy using an injection of aqueous phenol into the lumbar chain.