Phenol sympathectomy for vascular occlusive disease.

Surgical lumbar sympathectomy is often performed as a last resort in treating peripheral vascular occlusive disease. However, the variable success rate and the morbidity of this procedure prompted us to examine phenol sympathectomy and to elucidate the factors which can be used to predict success with the procedure. During the past three years, 127 phenol sympathectomies have been performed for peripheral vascular disease using a standard technique. The technique has proved simple and harmless. The results of a prospective study of 52 patients indicate that it is possible to predict the chance of success after this procedure by using a combination of clinical criteria and systolic pressure measurements at the ankle. A good response is anticipated in patients with rest pain or night pain if the systolic pressure at the ankle is greater than 35 millimeters of mercury. Patients with gangrene of the digits responded if the pressure at the ankle was greater than 60 millimeters of mercury.