Computed tomography fluoroscopy-guided chemical lumbar sympathectomy: simple, safe and effective

Australas Radiol. 2002 Jun;46(2):163-6. doi: 10.1046/j.1440-1673.2001.01027.x.


Demographic, clinical and laboratory data were retrospectively collected from records of 146 cases of CT fluoroscopy-guided chemical lumbar sympathectomy for the palliation of inoperable peripheral vascular disease (PVD) between January 1997 and August 1999. Of these, 16% had claudication, 39% had rest pain and 44% had ischaemic ulcers or gangrene. Seventy-three percent of elective cases were outpatients. At 3 months, 27 cases were lost to follow up, leaving 119 cases. Within 3 months, improvement, defined as doubling of the walking distance, cessation of rest pain or healing of ulcers, occurred in 30.3% of cases. No change was observed in 45.4% of cases and 24.3% of cases deteriorated. Patients with ulcers or gangrene had significantly poorer results than those without any ischaemic lesions, as only 19% versus 39% of patients improved (P < 0.05). The presence of hypertension, diabetes mellitus, hyperlipidaemia and smoking had no value in predicting clinical outcome (P > 0.05). There were no major complications noted. CT fluoroscopy-guided chemical lumbar sympathectomy is safe and effective, with a complication rate of less than 1%, and efficacy of at least 30% measured within 3 months. It is a simple and minimally invasive procedure, easily performed on an outpatient basis. CT fluoroscopy-guided chemical lumbar sympathectomy should be considered for all patients in the early stages of inoperable PVD.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Fluoroscopy
  • Humans
  • Lumbosacral Region / innervation
  • Male
  • Middle Aged
  • Palliative Care
  • Peripheral Vascular Diseases / diagnostic imaging
  • Peripheral Vascular Diseases / surgery*
  • Postoperative Complications
  • Retrospective Studies
  • Sympathectomy, Chemical / methods*
  • Tomography, X-Ray Computed
  • Treatment Outcome