This is a 61-years old man with severe pain due to peripheral vascular disease. Lumbar sypmathectomy was advised. Under CT guidance, alcohol was injected along with some iodinated contrast into the peri-aortic space at the upper margin of the L3 body level (Figs. 1 ,2), bilaterally. At the end, we could see the contrast, both in the peri-aortic region, as well as along the psoas sheaths, marking the extent of the spread of the alcohol.
Chemical lumbar sympathectomy is relative easy to perform under CT guidance and the results are as good as surgical sympathectomy.
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