Original communication Society for Vascular Surgery| Volume 24, ISSUE 3, P469-479, September 1948

The surgical treatment of essential hypertension

IV. Case selection and technique as influencing results
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      A group of 250 patients have been followed for at least one year and not more than six, in whom the minimal procedure consisted of a total splanchnic nerve section with removal of the sympathetic chain above the ninth dorsal and below the second lumbar ganglia. More extensive procedures were tried in a selected group of patients but nothing can be said as yet about their being superior; the morbidity certainly rises with their use. The patients were grouped as being in an early, marked, and too advanced stage. For five years now none of the last group has been accepted. There were two anesthetic deaths in this series and no postoperative mortality. The results were excellent in the first, fair in the second, and poor in the third group. The possible role of a corticoadrenal factor in the maintenance of essential hypertension is stressed in such early cases in which splanchnic section has not been successful.
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