Since its introduction by Royle almost 40 years ago, lumbar sympathetic denervation has been widely used in the treatment of peripheral vascular disorders. Though one would expect that both the indications for sympathectomy and its clinical effectiveness would be well defined by now, a review of the literature gives one the impression that good agreement has not been reached with respect either to the selection of patients for operation or to the results of operative treatment. This results from the fact that very few of the reports can be directly compared with one another because of differences in the types of cases treated and in the method of evaluation of operative results. Because of these considerations, we felt it advisable to review our own experiences.
The records of 1,000 patients who were treated by lumbar sympathetic denervation were initially reviewed. We are here concerned primarily with those who