Lumber sympathectomy is of value in the management of all except:
Lumbar sympathectomy continues to be controversial. It is probablya useful procedure for selected patients with
a. Advanced peripheralarterial occlusive disease.
b. Although it is most appropriatefor patients with causalgia or hyperhidrosis.
c. Perform sympathectomy for patients with multisegmentalarterial occlusive disease undergoing aortoiliac reconstructionor for those with a history of the "blue toe" syndrome.
d. Both clinical judgment and noninvasive diagnostictechniques—particularly digital photoplethysmography-areimportant for selecting patients who may benefit from lumbarsympathectomy.
e. Patients with early foot ischemic rest pain andischemic ulcers or gangrene limited to the toes or the distalforefoot have been considered candidates.
f. Sympathectomymay be unnecessary if distal revascularization is possible.