Arterial reconstruction in Buerger's disease: by-pass to disease-free collaterals.
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.
Shindo
S
S
Second Department of Surgery, Yamanashi Medical University, Yamanashi, Japan. sshindo@res.yamanashi-med.ac.jp
Matsumoto
H
H
Ogata
K
K
Kubota
K
K
Kojima
A
A
Ishimoto
T
T
Iyori
K
K
Kobayashi
M
M
Tada
Y
Y
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