Lumbar Sympathectomy in the Treatment of Hypertensive Ischemic Ulcers of the Leg (Martorell's Syndrome)

Hypertensive ischemic ulcer (Martorell's syndrome) is an infrequent complication of hypertensive disease. The ulcers appear on the leg as necrotic areas. The pathogenesis is described as ischemia resulting in local gangrene due to obliterating lesions in the arterioles. Actual pathological sections were studied which showed hyaline degeneration between the endothelium and internal elastic lamina, and these changes are similar to those found in other localities in hypertensive patients. Lumbar sympathectomy results in healing of the ulcers.