Surgical treatment of Buerger's disease.
Forty of 266 patients with Buerger's disease underwent 47 vascular reconstructions: bypass in 38, thromboendarterectomy in 7 and replacement in 2. Indications for arterial reconstruction were ulceration or gangrene in 60%, claudication in 33.3% and rest pain in 6.7%. In a follow-up from 6 months to 8 years and 7 months, the overall patency rate was 24% in bypass, 0% in thromboendarterectomy and 100% in replacement. One hundred nine of the 266 patients underwent sympathetic denervation: lumbar in 92 (bilateral in 19) and thoracic in 17. In the course of 11 years follow-up study, 23 cases required amputation of the extremity. A good initial result gradually gave way to recurrence unless the patients discontinued smoking. The most important factor which decides natural history of Buerger's disease is smoking.
D000328:Adult; D000671:Amputation, Surgical; D000792:Angiography; D001012:Aorta, Abdominal / Q000601:surgery; D001166:Arteriovenous Shunt, Surgical; D004691:Endarterectomy; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D005500:Follow-Up Studies; D005542:Forearm / Q000098:blood supply; D006801:Humans; D007083:Iliac Artery / Q000601:surgery; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D009132:Muscles / Q000098:blood supply; D011150:Popliteal Artery / Q000601:surgery; D013562:Sympathectomy; D013919:Thromboangiitis Obliterans / Q000601:surgery*; D014182:Transplantation, Autologous; D014680:Veins / Q000637:transplantation