title: Arterial reconstruction in Buerger's disease: by-pass to disease-free collaterals.
abstract: 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
  
  
  
  METHODS
  retrospective review.
  
  
  METHODS
  University hospital, hospitalized patients.
  
  
  METHODS
  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.
  
  
  METHODS
  bypass surgery with autogenous vein graft.
  
  
  METHODS
  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.
authors.affiliation: Second Department of Surgery, Yamanashi Medical University, Yamanashi, Japan. sshindo@res.yamanashi-med.ac.jp
authors.forename: S
authors.initials: S
authors.lastname: Shindo
authors.forename: H
authors.initials: H
authors.lastname: Matsumoto
authors.forename: K
authors.initials: K
authors.lastname: Ogata
authors.forename: K
authors.initials: K
authors.lastname: Kubota
authors.forename: A
authors.initials: A
authors.lastname: Kojima
authors.forename: T
authors.initials: T
authors.lastname: Ishimoto
authors.forename: K
authors.initials: K
authors.lastname: Iyori
authors.forename: M
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Y
authors.initials: Y
authors.lastname: Tada
mesh_terms: D000328:Adult; D001132:Arm / Q000098:blood supply* / Q000503:physiopathology / Q000601:surgery*; D003097:Collateral Circulation / Q000502:physiology*; D005260:Female; D006801:Humans; D007511:Ischemia / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery*; D007866:Leg / Q000098:blood supply* / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D013919:Thromboangiitis Obliterans / Q000150:complications* / Q000503:physiopathology / Q000601:surgery*; D016909:Tibial Arteries / Q000503:physiopathology / Q000601:surgery; D014656:Vascular Surgical Procedures