Clinical outcomes of extended endovascular recanalization of 16 consecutive Buerger’s disease patients

Abstract

Objective Buerger’s disease is one of the worst diseases causing peripheral artery occlusions (especially lower extremity) with increased morbidity and mortality. Endovascular treatment of the diseased arteries gains preference over bypass surgery nowadays. Here, we aimed to present the clinical outcomes of 16 consecutive Buerger’s disease patients underwent extended endovascular recanalization which is a new technique to restore direct blood flow to at least one foot artery, with the performance of angioplasty for each tibial and foot artery obstructions. Methods A total of 16 consecutive patients with confirmed diagnosis of Buerger’s disease that percutaneously treated in our center between February 2014 and March 2018 were included in the study. The mean age of the patients was 44.25 ± 4.28 ranging from 36 to 50 years. After physical examination and complementary diagnostic tests, performance of extended angioplasty for occluded arteries was intended to restore direct blood flow to at least one of the blow-the-knee arteries. Results A successful extended endovascular treatment was performed in 20 of 22 limbs, achieving a technical success of 91%. All patients were successfully discharged without any complication. Mean follow-up duration was 21.43 ± 7.08 months. Reintervention was performed in one patient and minor amputation was needed in one of the failed limbs. Limb salvage rate was 100%. A significant difference was observed based on Rutherford classification, ankle brachial index, direct blood flow to foot, presence of ulcer and rest pain when compared before and after the intervention. Conclusion We showed successful extended endovascular recanalization of Buerger’s disease patients with a high technical success rate and sustained clinical improvement. Extended endovascular recanalization could be a therapeutic option in Buerger’s disease patients, since they are not good candidates for surgery.

Patterns of arterial involvement and feasibility of revascularization in thromboangiitis obliterans: a tertiary care centre experience

“…Graziani et al and Kacmaz et al reported a 100% limb salvage rate after endovascular recanalization in patients with TAO. 18,19 In our study, we have had patency rates of 66.6% after angioplasty and 56.2% after bypass procedures.…”

Long-term outcomes of large artery thromboangiitis obliterans and comparison with small artery thromboangiitis obliterans

“…[ 18 ] Recently advanced less-invasive endovascular treatment is a technically feasible and potentially effective treatment modality for TAO. [ 22 , 28 – 30 ] However, despite more aggressive and advanced therapeutic options, there remains a high rate of amputations associated with TAO. [ 1 – 4 ]…”

“…[18] Recently advanced less-invasive endovascular treatment is a technically feasible and potentially effective treatment modality for TAO. [22,[28][29][30] However, despite more aggressive and advanced therapeutic options, there remains a high rate of amputations associated with TAO. [1][2][3][4] TAO has been considered to be limited to the small-and medium-sized arteries of the distal extremities affecting younger smokers.…”

Enfermedad de buerger presentación de caso y revisión de la literatura

“…En el tratamiento endovasuclar de la enfermedad de Buerger, se ha determinado, según varios estudios, que la tasa de éxito técnico es alta, del 87,5% (Firat, 2019), 91% (Kacmaz, 2019), 82% (Uyanik, 2021). Y la tasa de salvamento de la extremidad del 100% (Kacmaz, 2019), 92% (Modaghegh, 2017), 87,5% (Rodoplu, 2020), 93,3 % (Uyanik, 2021.…”

“…En el estudio de Kacmaz (2019), todos los pacientes (16) que fueron intervenidos endovascularmente fueron dados de alta con éxito y sin reportarse ninguna complicación. Los pacientes que presentaron ulceras isquémicas lograron obtener una cicatrización completa de la herida en 3,9 ± 2.…”