Pattern of Arterial Occlusion in Buerger's Disease

Shionoya, Shigehiko; Harada, Masafumi; Kawai, Soshi; Seko, Toshiyuki; Ban, Ichiro

doi:10.1177/000331978203300603

Cited by 20 publications

(4 citation statements)

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“…If the patient continues to smoke, the disease may affect the upper limbs; approximately 30% of patient with Buerger's disease have involvement of their upper extremities. 13 Small-and medium-sized arteries are usually involved, and the forearm, calf, or digital arteries may be occluded. The femoral and brachial arteries are usually not involved.…”

Section: Discussionmentioning

confidence: 99%

Study of Lumbar Sympathectomy in Thromboangiitis Obliterans Patient in Kbnims

Devani¹,

Kathare²,

Veerendra³

2018

jebmh

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BACKGROUND The aim of this study was to evaluate the effect of lumbar sympathectomy in thromboangiitis obliterans patients. The present study has been conducted on 50 consecutive cases of thromboangiitis obliterans admitted to the hospital attached to KBNIMS, Kalaburagi. In the present study of 50 cases, age ranged from 30 yrs. to 60 yrs. at the onset of disease. In this study all 50 cases were chronic smokers with minimum duration of 2 yrs. of smoking, 30 patients treated with lumbar sympathectomy and 5 patients with lumbar sympathectomy with amputation and 15 patients with only amputation. Lumbar sympathectomy improved the symptoms clinically with relief of rest pain and also decreased the level of amputation. MATERIALS AND METHODS The present study is a prospective study conducted on 50 consecutive cases of Thromboangiitis obliterans during the period of May 2016 to November 2017 in KBNIMS, Kalaburagi.

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Section: Discussionmentioning

confidence: 99%

Study of Lumbar Sympathectomy in Thromboangiitis Obliterans Patient in Kbnims

Devani¹,

Kathare²,

Veerendra³

2018

jebmh

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“…The disease usually starts in one limb but both the lower limbs may be affected. If the patient continues to smoke, the disease may affect the upper limbs; approximately 30% of patient with Buerger disease have involvement of their upper extremities 40. Small- and medium-sized arteries are usually involved and the forearm, calf, or digital arteries may be occluded.…”

Section: Discussionmentioning

confidence: 99%

Management of thromboangiitis obliterans using distraction osteogenesis: A retrospective study

Kulkarni¹,

Gs²,

Shyam³

et al. 2011

IJOO

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Background:Thromboangiitis obliterans (TAO), also known as Buerger disease, is characterized by thrombosis in medium-sized arteries and veins along with a marked inflammatory response. TAO can be managed by using the principle of distraction osteogenesis to induce neoangiogenesis. We report thirty patients of TAO in the age-group of 20–50 years were treated with the Ilizarov method.Materials and Methods:Patients with severe rest pain (n=30), absent distal pulsation (n=30) and ulcer (n=6) and/or gangrene of the toes (n=4), who had failed the conservative pharmacological modalities of treatment were included. A lateral tibial corticotomy was performed and distraction applied by use of olive wire. A two-ring frame was used for all cases.Results:Of the 30 cases, 25 patients became pain free while 1 had partial relief of pain. The four patients worsened on treatment and developed frank infection were amputed. The average distraction was 1.8±0.3 mm (range: 1.5–2.2 cm). The mean consolidation period was 98±11 days, after which the fixator was removed. The total duration of treatment was 122±23 days. There were two cases of osteomyelitis in our series; both healed after debridement and both patients had good result, with relief of pain. The ulcers started healing by 4–6 weeks.Conclusion:The principle of the distraction osteogenesis including neoangiogenesis can be used for treatment of TAO and has an acceptable complication rate.

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“…After the crural arteries are affected, the pattern of infrapopliteal arterial occlusion is fixed and the more proximal extension of the obstructive lesion in the main artery occurs less frequently, in contrast to an incessant deterioration of peripheral circulation in the foot or the toe, which is not discernible by usual angiography [8].…”

Section: What Is Buerger's Disease?mentioning

confidence: 98%

What is Buerger's disease?

Shionoya

1983

World j. surg.

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In analyzing our observations of 115 patients with Buerger's disease during a recent 4-year period, the following results were obtained. First, Buerger's disease is primarily a disease of the small-and medium-sized vessels of the extremity. The disease commences peripherally and reaches the infrapopliteal or forearm arteries within a short time after the onset of symptoms. The majority of the patients have 3-or 4-limb involvement. Although the first ischemic manifestation is variable, a trophic lesion is the chief symptom at the first examination.Second, in contrast to an incessant deterioration of the peripheral circulation, proximal extension is less frequent. The skip lesion plays an important role in proximal progression of the obstructive lesion in the main artery.Third, although direct arterial surgery is infrequently feasible because of the distal occlusive process, successful arterial revascularization is most effective for healing of ulceration. All efforts should be concentrated on limb salvage.Furthermore, microabscess consisting of giant cells, epithelioid cells, and ieukocytes lends the most characteristic appearance to the thrombotic lesion at the early stage. General architecture of the vessel wall is well preserved at the healed stage.Finally, the etiology remains unknown. In this regard, however, we have a very strong clue in the astoundingly close relationship between the use of tobacco and the occurrence of the disease. If the patient absolutely abandons smoking, the natural history of the disease is uneventful.

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Pattern of Arterial Occlusion in Buerger's Disease

Cited by 20 publications

References 4 publications

Study of Lumbar Sympathectomy in Thromboangiitis Obliterans Patient in Kbnims

Study of Lumbar Sympathectomy in Thromboangiitis Obliterans Patient in Kbnims

Management of thromboangiitis obliterans using distraction osteogenesis: A retrospective study

What is Buerger's disease?

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