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Sympathetic blockage and reversed saphenous vein by-pass grafting: An experimental study

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Summary

The value of sympathetic blockade as an adjunct to femoropopliteal arterial reconstruction is disputed. The effect of lumbar sympathectomy and of pharmacological adrenergic blockade with intraarterial reserpine on the patency of experimental autogenous vein by-pass grafts was evaluated.

Thirty-one grafts by-passing a chronic superficial femoral artery occlusion were inserted in adult mongrel dogs. The mean graft flow was reduced by a distal stenosis, below a known critical level of 60 ml per minute. In 10 grafts, no further procedure was done. These grafts occluded. In 11 grafts, an ipsilateral lumbar sympathectomy was done. Near normal flow was restored in 9 and these remained patent. No flow increase was achieved in 2 and these failed. In a further 10 grafts, 0.5 mg of reserpine was injected intra-arterially. In 9 of these grafts, near normal blood flow was restored and these remained patent. In one graft, no flow increase was achieved, and the graft failed. The role of sympathetic blockade in reconstructive surgery is discussed. It is concluded that a trial of intra-arterial reserpine in femoropopliteal arterial surgery is warranted.

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References

  • Abboud, F. F., Eckstein, J. W., Lawrence, M. S., Hoak, J. C. 1967. Preliminary observations on the use of intra-arterial reserpine in Raynaud's phenomenon. Circ. 36 (Suppl.) 2, 49

    Google Scholar 

  • Barner, H. B., Judd, D. R., Kaiser, G. C., Willman, V. L., Hanlon, C. R. 1968. Blood flow in femoropopliteal by-pass vein grafts. Arch. Surg. 96, 619.

    PubMed  CAS  Google Scholar 

  • Bernhard, V. M., Ashmore, C. S., Rodgers, R. E., Evans, W. E., 1971. Operative blood flow in femoropopliteal and femorotibial grafts for lower extremity ischaemia. Arch. Surg. 103, 595.

    PubMed  CAS  Google Scholar 

  • Bouchier-Hayes, D., Fitzgerald, P. A. M. 1977. The influence of proximal stenosis, distal stenosis and mean blood flow on the early patency of vein by-pass grafts. Irish. J. Med. Sci. 146, 15.

    Article  PubMed  CAS  Google Scholar 

  • Cappelen, C., Hall, K. V. 1967. Electromagnetic blood flowmetry in clinical surgery. Acta Chir Scand (Suppl.), 368, 3.

    Google Scholar 

  • Crawford, S., Garret, W., De Bakey, M., Howell, J. F. 1966. Occlusive disease of the femoral artery and its branches. Surg. Clin. Amer. 46, 991.

    CAS  Google Scholar 

  • Cronenwett, J. L., Lindenauer, S. M., 1977. Direct measurement of arteriovenous anastomotic blood flow after lumbar sympathectomy. Surgery 82, 82.

    PubMed  CAS  Google Scholar 

  • Cronestrand, R., Ekestrom, S., 1970. Blood flow after peripheral arterial reconstruction. Scand. J. Thorac. Cardiovasc. Surg. 4, 159.

    PubMed  CAS  Google Scholar 

  • Little, J. M., Shiel, A. G. R., Loewenthal, J., Goodman, A. H. 1968. Prognostic value of intraoperative blood flow measurements in femoropopliteal bypass vein grafts. Lancet ii, 648.

    Article  Google Scholar 

  • Mannick, J. A., Jackson, B. T., 1966. Haemodynamics of arterial surgery in athersclerotic limbs. Surg. 59, 713.

    CAS  Google Scholar 

  • May, A. G., Van Der Berg, L., DeWeese, J., Rob, C. G. 1963a. Critical arterial stenosis. Surgery 55, 250.

    Google Scholar 

  • May, A. G., DeWeese, J. A., Rob, C. G. 1963b. Effect of sympathectomy on blood flow in arterial stenosis. Ann. Surg. 158, 182.

    Article  PubMed  CAS  Google Scholar 

  • Parks, V. J., Skinner, S. L., Whelan, R. 1961. Mechanisms in the return of vascular tone following sympathectomy in man. Circ. Res. 9, 1026.

    PubMed  CAS  Google Scholar 

  • Porter, J. M., Lindell, T. D., Leung, B. J., Reiwey, C. G. 1972. Effect of intra-arterial injections of reserpine on vascular wall catecholamine content. Surg. Forum 13, 183.

    Google Scholar 

  • Strandness, D. E., Sumner, D., 1975. Hemodynamics for Surgeons. New York, Grune and Stratton, p. 323.

    Google Scholar 

  • Terry, H. J., Allan, J. S., Taylor, G. W., 1970. The effect of adding lumbar sympathectomy to reconstructive arterial surgery in the lower limb. Br. J. Surg. 57, 51.

    Article  PubMed  CAS  Google Scholar 

  • Weale, F. E., 1964. Haemodynamics of incomplete arterial obstruction. Br. J. Surg. 51, 689.

    Article  PubMed  CAS  Google Scholar 

  • Weissenhofer, W., Schenk, W. G., Jr. 1973. Effect of sympathectomy on blood flow through stenotic vessels during exercise. Surg. 74, 734.

    CAS  Google Scholar 

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Bouchier-Hayes, D., MacGowan, W.A.L. Sympathetic blockage and reversed saphenous vein by-pass grafting: An experimental study. I.J.M.S. 147, 236–241 (1978). https://doi.org/10.1007/BF02939410

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