Effect of surgical sympathectomy on arterial blood flow in reflex sympathetic dystrophy: Doppler US assessment.

PURPOSE: To assess duplex Doppler ultrasound (US) in providing objective, reproducible measurements of blood flow in patients with reflex sympathetic dystrophy (RSD) who underwent surgical sympathectomy. MATERIALS AND METHODS: Findings in eight adult patients with RSD who were evaluated with arterial duplex Doppler US after surgical sympathetectomy were retrospectively reviewed. Pulsatility index (PI) and waveform characteristics were compared to clinical findings (temperature and sudomotor state) in sympathectomized limbs. RESULTS: Warm and dry limbs yielded a consistently low PI (usually less than 2) and biphasic waveform. Cold and clammy limbs, which indicated failed sympathectomy, produced a high PI (usually greater than 4) and triphasic waveform. The Doppler waveform promptly reverted with the return of sympathetic tone in patients who had clinical relapse. CONCLUSION: Duplex Doppler US may be useful for objective follow-up of RSD patients after sympathectomy.