Abstract
To investigate the current practice of chemical lumbar sympathectomy by vascular surgeons in Scotland. Postal questionnaire survey of all practising vascular surgeons in Scotland (n = 40) identified from the list of members of the Vascular Society of Great Britain and Ireland. Most surgeons (30 of the 34 respondents, 88%) practise chemical lumbar sympathectomy. Their main indications are in line with current recommendations in relevant publications. Controversial areas include its use as an adjunct to operation and in treating diabetic feet. The procedure is done by vascular surgeons (16 of 34 respondents, 47%) and anaesthetists or radiologists (14 of the 34 respondents, 41%). There is a wide variation in the technical aspects of the procedure. All respondents make a clinical assessment of outcome. The role of chemical lumbar sympathectomy is likely to remain controversial because of the lack of a valid prognostic marker, technical variability, and the fact that it is often used in elderly patients.
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