Direct Arterial Reconstruction in Buerger's Disease

Abstract

During the last six years the authors surgically treated 132 patients with Buerger's disease. They were able to perform arterial reconstruction in 14. Nonhealing ulcers and impending gangrene were the most frequent indications (62.2%). The type and number of surgical procedures were as follows: aorto femoral (1), iliofemoral (2), femoropopiteal (3), femorocrural (3), by-passes and throm boendarterectomy with patch angioplasty (5). There were no perioperative or postoperative deaths. Early thrombosis oc curred in 3 patients. Of the 11 patients with patent arterial reconstructions, 3 showed occlusion within the first year. The cumulative patency rate was 57%. Although the patency rates for direct arterial surgery in Buerger's disease are not as good as those reported for arteriosclerosis obliterans, the authors believe that, in appropriate cases, arterial reconstructive procedures should be tried to achieve better healing of the trophic lesions without major amputation.