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A Journal on Angiology
Official Journal of the , the International Union of Phlebology and the
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,899
International Angiology 2002 September;21(3):228-32
Arterial reconstruction in Buerger’s disease: by-pass to disease-free collaterals
Shindo S., Matsumoto H., Ogata K., Kubota K., Kojima A., Ishimoto T., Iyori K., Kobayashi M., Tada Y.
From the Second Department of Surgery, Yamanashi Medical University, Yamanashi, Japan
Background. Arterial reconstructions for ischemia in patients with Buerger’s disease are technically challenging. This retrospective review was conducted to identify the critical factor for a successful outcome in bypass surgery for Buerger’s disease.
Methods. Design of study: retrospective review. Setting: University hospital, hospitalized patients. Patients: since 1993, we performed 10 arterial reconstructions in 8 patients with Buerger’s disease. There were 8 tibial artery bypasses and 2 collateral artery bypasses. One bypass was performed in the upper extremity. Interventions: bypass surgery with autogenous vein graft. Main outcome measurements: graft patency.
Results. Over a mean follow-up period of 41.8 months, there were 3 graft occlusions. Of these, 2 were of bypasses to a patent but diseased tibial artery. One graft was occluded due to a toe stenosis which had been previously detected. The 2 collateral artery bypasses were patent at the last follow-up.
Conclusions. In Buerger’s disease, distal arterial reconstruction is frequently necessary to prevent ischemic limb loss. Collateral artery bypass is an option when the main arteries are affected by the disease. A patent but diseased artery should be avoided as a target for reconstruction.