Sympathectomy for occlusive vascular disease has had a hard time.—de Takats
The present status of sympathectomy in the treatment of arterial occlusive disease is unsettled. It is no longer the mainstay of operative treatment, as it was in 1952.11 Neither is it merely an adjunctive procedure to be done routinely in combination with arterial reconstruction.5,18 Its true role may defy scientific analysis4 or it may be the treatment of choice for aged persons19 or others unsuited for angioplasty.
The position of lumbar ganglionectomy would be clearer if a true prediction regarding its effects could be made in a given patient. Despite the many clinical and laboratory methods of testing which have been used, no single examination emerges which reliably assesses preoperatively what the operation will accomplish.6,16 Such estimation of sympathectomy results is neither impossible as suggested by Nelson and Trimble,13 nor 90%