title: Critical limb ischemia in a young man: saddle embolism or unusual presentation of thromboangiitis obliterans?
abstract: Thromboangiitis obliterans (TAO), also known as Buerger's disease, is a rare cause of peripheral arterial disease in western countries. Tobacco smoking is strongly correlated to the pathogenesis of this inflammatory vascular disease. We report the case of a 32-year-old tobacco and cannabis consumer presenting with right critical limb ischemia. Computerized tomography angiography revealed a bilateral tibioperoneal arterial occlusion and an aortoiliac saddle embolus. The patient was treated with intravenous heparin, transcatheter thrombolysis, and selective Fogarty embolectomy. Instrumental and laboratory examinations revealed that patient's most likely diagnosis was TAO. Arterial embolism is uncommon in Buerger's disease but should be always excluded in these patients.
authors.affiliation: Vascular Surgery Department, Sud Gironde Community Hospital, rue Langevin, 33210 Langon, France.
authors.forename: Federico
authors.initials: F
authors.lastname: Bucci
authors.affiliation: General and Vascular Surgery Department, "Umberto I" University Hospital, Viale del Policlinico, 00186 Rome, Italy.
authors.forename: Adriano
authors.initials: A
authors.lastname: Redler
authors.affiliation: General and Vascular Surgery Department, "Umberto I" University Hospital, Viale del Policlinico, 00186 Rome, Italy.
authors.forename: Leslie
authors.initials: L
authors.lastname: Fiengo