title: Corkscrew Collateral Vessels in Buerger Disease: Vasa Vasorum or Vasa Nervorum.
abstract: OBJECTIVE
  To investigate the origin of "corkscrew" collateral vessels around the occluded popliteal artery in patients with Buerger disease by Doppler ultrasound (US) and magnetic resonance (MR) imaging in tandem with digital subtraction angiography (DSA).
  
  
  METHODS
  Between January 2013 and June 2015, 42 patients diagnosed with Buerger disease were identified retrospectively. Patients in whom occlusion of the popliteal artery was found on DSA of the lower extremity were subjected to Doppler US and MR imaging prospectively. Fifteen of 42 patients were identified as having the required characteristics, of whom 10 participated in the present study.
  
  
  RESULTS
  Ten patients with occlusion of the popliteal artery were selected for inclusion, and 12 lower limbs of these patients were investigated. The study cohort comprised one woman and nine men with a mean age of 41 years ± 10 (standard deviation; range, 39-58 y). Corkscrew collateral vessels identified on DSA examinations were also identified on secondary imaging (Doppler US and MR imaging) in all patients except one in whom the popliteal artery was reconstituted after short-segment occlusion. The origin of the corkscrew collateral vessels was identified as the vasa nervorum of the tibial nerve in nine patients.
  
  
  CONCLUSIONS
  Data from the present study suggest that corkscrew collateral vessels at the knee level in patients with Buerger disease originate from the vasa nervorum of the tibial nerve rather than the vasa vasorum of the popliteal artery if the latter is occluded.
authors.affiliation: Departments of Interventional Radiology, Istanbul University, Cerrahpasa Faculty of Medicine, Fatih, Istanbul 34098, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Baş
authors.affiliation: Departments of Interventional Radiology, Istanbul University, Cerrahpasa Faculty of Medicine, Fatih, Istanbul 34098, Turkey.
authors.forename: Atilla S
authors.initials: AS
authors.lastname: Dikici
authors.affiliation: Departments of Interventional Radiology, Istanbul University, Cerrahpasa Faculty of Medicine, Fatih, Istanbul 34098, Turkey. Electronic address: drfgulsen@yahoo.com.
authors.forename: Fatih
authors.initials: F
authors.lastname: Gülşen
authors.affiliation: Departments of Interventional Radiology, Istanbul University, Cerrahpasa Faculty of Medicine, Fatih, Istanbul 34098, Turkey.
authors.forename: Cesur
authors.initials: C
authors.lastname: Samancı
authors.affiliation: Departments of Interventional Radiology, Istanbul University, Cerrahpasa Faculty of Medicine, Fatih, Istanbul 34098, Turkey.
authors.forename: İsmail
authors.initials: İ
authors.lastname: Mihmanlı
authors.affiliation: Cardiovascular Surgery, Istanbul University, Cerrahpasa Faculty of Medicine, Fatih, Istanbul 34098, Turkey.
authors.forename: Kazım
authors.initials: K
authors.lastname: Beşirli
authors.affiliation: Departments of Interventional Radiology, Istanbul University, Cerrahpasa Faculty of Medicine, Fatih, Istanbul 34098, Turkey.
authors.forename: Furuzan
authors.initials: F
authors.lastname: Numan
authors.affiliation: Departments of Interventional Radiology, Istanbul University, Cerrahpasa Faculty of Medicine, Fatih, Istanbul 34098, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Kantarci
mesh_terms: D000328:Adult; D015901:Angiography, Digital Subtraction; D003097:Collateral Circulation; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D011150:Popliteal Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013919:Thromboangiitis Obliterans / Q000000981:diagnostic imaging* / Q000503:physiopathology; D013979:Tibial Nerve / Q000098:blood supply*; D018615:Ultrasonography, Doppler, Color; D014650:Vasa Nervorum / Q000000981:diagnostic imaging* / Q000503:physiopathology; D014651:Vasa Vasorum / Q000000981:diagnostic imaging* / Q000503:physiopathology