The use of laser Doppler flowmetry and transcutaneous oxygen measurements to evaluate the efficacy of sympathectomy in the treatment of arterial occlusive disease

Research output: Contribution to journalArticle

Abstract

Previous attempts to establish the efficacy of sympathectomy as a treatment for arterial occlusive disease in patients not amenable to vascular reconstruction have resulted in conflicting conclusions. The operation's effect on rest pain, ischemic lesions, and major amputations may not be valid and objective criteria for evaluating the effect of sympathectomy. The purpose of this investigation was to use laser Doppler flow analysis (LDF), transcutaneous oxygenation studies (TcPO2), and other tools of the noninvasive vascular laboratory to evaluate objectively the effect of sympathectomy on blood flow in limbs with arterial occlusive disease. Twenty- two patients undergoing either unilateral sympathectomy or chemical sympathetic block had LDF, TcPO2, extremity-brachial blood pressure indexes (EBI), and digital temperatures measured on the involved limb and the contralateral control limb before and after the procedure. Ten procedures were done for nonvascular indications on patients with no known vascular disease. Twelve were done for occlusive vascular disease. To correct for spontaneous day-to-day changes, results were recorded as a ratio of sympathectomized limb values to control limb values. The changes in the ratios as a result of the procedure were analyzed. In the normal group, significant improvement was seen in digital temperature, TcPO2 with the electrode at room temperature, and digital LDF. In the abnormal group significant improvement occurred only in digital temperature, and there was no improvement in limb oxygenation or blood flow. Based on these results, we conclude that sympathectomy has little, if any, effect on blood flow in limbs with arterial occlusive disease.

Original languageEnglish (US)
Pages (from-to)19-22
Number of pages4
JournalJournal of Vascular Technology
Volume18
Issue number1
StatePublished - 1994

Fingerprint

Arterial Occlusive Diseases
Laser-Doppler Flowmetry
Sympathectomy
Extremities
Oxygen
Lasers
Temperature
Therapeutics
Vascular Diseases
Blood Vessels
Chemical Sympathectomy
Amputation
Electrodes
Arm
Blood Pressure
Pain

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

@article{256fd65561b149aeb94ff330489fd9f9,
title = "The use of laser Doppler flowmetry and transcutaneous oxygen measurements to evaluate the efficacy of sympathectomy in the treatment of arterial occlusive disease",
abstract = "Previous attempts to establish the efficacy of sympathectomy as a treatment for arterial occlusive disease in patients not amenable to vascular reconstruction have resulted in conflicting conclusions. The operation's effect on rest pain, ischemic lesions, and major amputations may not be valid and objective criteria for evaluating the effect of sympathectomy. The purpose of this investigation was to use laser Doppler flow analysis (LDF), transcutaneous oxygenation studies (TcPO2), and other tools of the noninvasive vascular laboratory to evaluate objectively the effect of sympathectomy on blood flow in limbs with arterial occlusive disease. Twenty- two patients undergoing either unilateral sympathectomy or chemical sympathetic block had LDF, TcPO2, extremity-brachial blood pressure indexes (EBI), and digital temperatures measured on the involved limb and the contralateral control limb before and after the procedure. Ten procedures were done for nonvascular indications on patients with no known vascular disease. Twelve were done for occlusive vascular disease. To correct for spontaneous day-to-day changes, results were recorded as a ratio of sympathectomized limb values to control limb values. The changes in the ratios as a result of the procedure were analyzed. In the normal group, significant improvement was seen in digital temperature, TcPO2 with the electrode at room temperature, and digital LDF. In the abnormal group significant improvement occurred only in digital temperature, and there was no improvement in limb oxygenation or blood flow. Based on these results, we conclude that sympathectomy has little, if any, effect on blood flow in limbs with arterial occlusive disease.",
author = "Hobday, {Timothy James} and Heser, {J. L.} and Rooke, {Thom W}",
year = "1994",
language = "English (US)",
volume = "18",
pages = "19--22",
journal = "Journal for Vascular Ultrasound",
issn = "1544-3167",
publisher = "Society of Vascular Ultrasound",
number = "1",

}

TY - JOUR

T1 - The use of laser Doppler flowmetry and transcutaneous oxygen measurements to evaluate the efficacy of sympathectomy in the treatment of arterial occlusive disease

AU - Hobday, Timothy James

AU - Heser, J. L.

AU - Rooke, Thom W

PY - 1994

Y1 - 1994

N2 - Previous attempts to establish the efficacy of sympathectomy as a treatment for arterial occlusive disease in patients not amenable to vascular reconstruction have resulted in conflicting conclusions. The operation's effect on rest pain, ischemic lesions, and major amputations may not be valid and objective criteria for evaluating the effect of sympathectomy. The purpose of this investigation was to use laser Doppler flow analysis (LDF), transcutaneous oxygenation studies (TcPO2), and other tools of the noninvasive vascular laboratory to evaluate objectively the effect of sympathectomy on blood flow in limbs with arterial occlusive disease. Twenty- two patients undergoing either unilateral sympathectomy or chemical sympathetic block had LDF, TcPO2, extremity-brachial blood pressure indexes (EBI), and digital temperatures measured on the involved limb and the contralateral control limb before and after the procedure. Ten procedures were done for nonvascular indications on patients with no known vascular disease. Twelve were done for occlusive vascular disease. To correct for spontaneous day-to-day changes, results were recorded as a ratio of sympathectomized limb values to control limb values. The changes in the ratios as a result of the procedure were analyzed. In the normal group, significant improvement was seen in digital temperature, TcPO2 with the electrode at room temperature, and digital LDF. In the abnormal group significant improvement occurred only in digital temperature, and there was no improvement in limb oxygenation or blood flow. Based on these results, we conclude that sympathectomy has little, if any, effect on blood flow in limbs with arterial occlusive disease.

AB - Previous attempts to establish the efficacy of sympathectomy as a treatment for arterial occlusive disease in patients not amenable to vascular reconstruction have resulted in conflicting conclusions. The operation's effect on rest pain, ischemic lesions, and major amputations may not be valid and objective criteria for evaluating the effect of sympathectomy. The purpose of this investigation was to use laser Doppler flow analysis (LDF), transcutaneous oxygenation studies (TcPO2), and other tools of the noninvasive vascular laboratory to evaluate objectively the effect of sympathectomy on blood flow in limbs with arterial occlusive disease. Twenty- two patients undergoing either unilateral sympathectomy or chemical sympathetic block had LDF, TcPO2, extremity-brachial blood pressure indexes (EBI), and digital temperatures measured on the involved limb and the contralateral control limb before and after the procedure. Ten procedures were done for nonvascular indications on patients with no known vascular disease. Twelve were done for occlusive vascular disease. To correct for spontaneous day-to-day changes, results were recorded as a ratio of sympathectomized limb values to control limb values. The changes in the ratios as a result of the procedure were analyzed. In the normal group, significant improvement was seen in digital temperature, TcPO2 with the electrode at room temperature, and digital LDF. In the abnormal group significant improvement occurred only in digital temperature, and there was no improvement in limb oxygenation or blood flow. Based on these results, we conclude that sympathectomy has little, if any, effect on blood flow in limbs with arterial occlusive disease.

UR - http://www.scopus.com/inward/record.url?scp=0028220145&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028220145&partnerID=8YFLogxK

M3 - Article

VL - 18

SP - 19

EP - 22

JO - Journal for Vascular Ultrasound

JF - Journal for Vascular Ultrasound

SN - 1544-3167

IS - 1

ER -