Chemical lumbar sympathectomy for lower limb rest pain associated with thromboangiitis obliterans

Abstract

Thromboangiitis obliterans (TAO) is often misdiagnosed and hence, there is enormous suffering by patients. Surgical options are limited in the management. Most of the drugs used for medical management do not alleviate pain or help in the healing of ischemic ulcer. Chemical lumbar sympathectomy (CLS) can help patients by relieving pain and improving blood flow to the affected area. It is a therapeutic option performed under local anesthesia with relatively less morbidity. Although the drugs used can cause neuritis, sympathectomy is a better option. Proper diagnosis and accurate neurolytic block helps in relieving patient suffering. A 30-year-old chronic smoker diagnosed to have TAO of the right lower limb underwent CLS with alcohol. The patient had good pain relief.