Evaluation of Arterial Reconstruction and Sympathectomy by Direct Stimulation Ergometry

Introduction  Aside from necrosis and limb loss, disability as expressed by intermittent claudication is certainly the greatest problem of the patient with arteriosclerosis of the lower extremities. It is safe to say the consensus is that claudication may be expected to be relieved promptly and effectively by arterial reconstruction, with pulse restoration. Opinions as to the efficacy of lumbar sympathectomy in this regard vary from one of no benefit to one of benefit in about three-fourths of the cases, but the degree of improvement is held to be less than that by reconstruction in any case. As with the evaluation of therapeutic procedures in general, such opinions are more valuable when they are subjected to objective scrutiny. It is precisely with our problem that this is difficult. While claudication means limping, the symptom actually complained of is pain, apparently of muscle origin; and, as with pain in general, the patient's