Lumbar sympathectomy is widely used in the treatment of peripheral vascular disease involving the lower extremity. The obvious increase in skin temperature postoperatively has led to the belief that there is a concommitant increase in perfusion of all tissues in the leg.
Recent evidence suggests that this increase in total blood flow represents, in the main, arteriovenous shunting with a little, if any effect on the nutritive blood flow at the tissue level. Studies aimed at investigating the effect of lumbar sympathectomy on regional tissue circulation have utilized the local clearance of radioactive isotopes. No significant change in the clearance of these substances in muscle have been noted following lumbar sympathectomy in man.
Tissue Blood Flow in the Canine Lower Limb Following Lumbar SympathectomyVASC ENDOVASCULAR SURG November 1972 6: 227-238,
increased blood supply is associated with decreased vascular permeability
The influence of the sympathetic nervous system on capillary permeability was studied in cats. The dye penetration from the blood through the synovial membrane was tested by perfusing the two knee joints, one of which was deprived of its sympathetic nerve supply by unilateral lumbosacral
sympathectomy.
In confirmation of previous experiments, it was found in a great majority of experiments that, in spite of marked vasodilatation, the dye excretion was considerably reduced on the sympathectomised side.
A permeability factor under the influence of the sympathetic nervous system has been postulated; its character and mechanism is still unknown.
Further unpublished experiments seem to support the view that increased blood supply is associated with decreased vascular permeability.
Res Exp Med (Berl) 173, 1--8 (1978)
sympathectomy.
In confirmation of previous experiments, it was found in a great majority of experiments that, in spite of marked vasodilatation, the dye excretion was considerably reduced on the sympathectomised side.
A permeability factor under the influence of the sympathetic nervous system has been postulated; its character and mechanism is still unknown.
Further unpublished experiments seem to support the view that increased blood supply is associated with decreased vascular permeability.
Res Exp Med (Berl) 173, 1--8 (1978)