A further operation is lumbar sympathectomy, which involves cutting the sympathetic nervous chain in the lower back. This chain controls the tone in the arterial wall. When the nerves are cut, the arteries permanently dilate and blood flow can increase. Sometimes both operations are combined.
The bypass operation is the same principle as in coronary bypass surgery, where atheroma blocks one of the coronary arteries and a vein is used to bypass the obstruction.
There is no doubt about the marvels of modern medicine, but how can we convince our patients to avoid the bad habits that lead to many of these problems?
Changing our diet and avoiding smoking would reduce the incidence of atheroma.
The diagnosis of intermittent claudication can be made on the history alone. When the doctor examines the legs, he may be unable to feel the pulses in the feet. This indicates obstruction to blood flow.
In the past, various drugs were used in an effort to dilate the narrowed arteries and improve the blood flow. Unfortunately, these have proved disappointing.
*258/71/1*
