Pain Management in Peripheral Vascular Disease

The progression of peripheral vascular disease exacts a terrible toll in accompanying pain in many patients. Various approaches to interventional pain management (diagnostic and neurolytic lumbar sympathectomy, ra diofrequency lesioning of the sympathetic chain, spinal cord stimulation) are reviewed, compared, and con trasted. The impact of concurrent medications (eg, heparin, low-molecular-weight heparin, coumadin, aspi rin, and nonsteroidal anti-inflammatory drugs) on per forming interventional procedures is also considered. An algorithm for disease management is presented.