[Effectiveness of lumbar sympathectomy in the treatment of occlusive peripheral vascular disease in lower limbs: systematic review].

BACKGROUND AND

OBJECTIVES

The aim of this work has been to check the scientific evidence on the efficacy of lumbar sympathectomy in the treatment of peripheral arterial disease of lower limbs.

MATERIAL AND

METHODS

Systematic review of the literature.

DATA SOURCE: MedLine, Embase, Cochrane Library, INHATA, CRD, BioMed Central, and ClinicalTrials.gov register. Mesh terms: sympathectomy, peripheral vascular disease, lower extremity, vascular therapy, iliac artery, femoral artery, popliteal artery.

INCLUSION CRITERIA: adult patients with occlusive peripheral arterial disease of lower limbs treated with sympathectomy. The quality was evaluated by means of the criteria of the CASP checklist and "ad hoc" questionnaire.

RESULTS

Four clinical trials and four observational studies were included. Sympathectomy did not show significant differences for mortality, amputations and grade of intermittent claudication. When it was assessed regarding local anaesthetics or prostaglandin-E1, differences were not detected. Chemical sympathectomy showed better results than surgical sympathectomy in hospital stance.

CONCLUSIONS

Evidence on the efficacy of sympathectomy does not show differences related to conventional treatments. Both sympathectomy techniques (surgical and chemical) do not report statistical differences regarding mortality or amputations.