Coronary artery dissection in a patient with Buerger's Disease

Abstract Buerger's disease, vasculitis of small and medium-sized blood vessels, is a non-atherosclerotic and progressive occlusive condition which frequently involves the distal part of the limbs. The occlusion of coronary arteries in Buerger's disease is a rare condition; however, coronary artery dissection has not been reported previously. Therefore, this paper presents a 45-year-old man who developed coronary artery dissection associated with Buerger's disease. The patient was treated successfully with coronary artery bypass grafting with the left internal mammary artery to the left anterior descending artery, and saphenous vein graft to the right coronary artery.

Clinical characteristics of Buerger's disease in Iran

To determine the clinical course of Buerger's disease as observed in two vascular surgery centers located in the capital of Iran. Case series. Sina and Imam Hospitals, Tehran, Iran, during the years 1997 to 2002. The records of all the patients admitted with Buerger's disease diagnosed on the basis of Shionoya's clinical criteria were studied. Their clinical characteristics, treatment offered and short-term follow-up results are described as frequencies and percentages. A total of 116 patients, aged 41.1 +/- 11.3 years, were enrolled. All patients were males; 99% of them were smokers with an average of 22.9 pack-years of tobacco use. Lower-extremity was affected in 102 [87.9%] patients, upper-extremity in 3 [2.6%] patients and both in 11 [9.5%]. The most frequent reasons for being referred to hospital were ischemic ulcers [90.5%], claudication [87.9%], paresthesia [75.9%], rest pain [66.4%], gangrene [60.3%], Raynaud's phenomenon [23.3%] and thrombophlebitis [9.5%]. Diagnostic arteriography, vascular bypass surgery and sympathectomy were performed in 60%, 24% and 83% of the patients, respectively. Sixty-eight patients [58.6%] had one of the following amputations: toe 36 [52.9%], transmetatarsal 3 [4.4%], below knee 25 [36.8%], finger 3 [4.4%] and above knee one [1.5%] patient. Since the studied hospitals are the referral centers for vascular surgery in Iran admitting patients with severe symptoms; therefore, a higher number of complications and amputations was found in the present study. Upper extremity involvement as well as the occurrence of thrombophlebitis and Raynaud's phenomenon was rather infrequent among the studied cases

Omentopexy for limb salvage in Buerger's disease: indications, technique and results.

Buerger's disease is a limb-threatening condition occurring in the young and productive age group and its management has always been a challenging problem. A large number of medical and surgical options have been suggested, but the quest for an ideal solution to this problem continues. Omentopexy for Buerger's disease is an attractive option, which is rapidly gaining popularity. We discuss the historical aspects, technical considerations and results of omental transfer for this limb-threatening condition. In doing so, the relevant literature on the subject has been extensively reviewed. In all published series, there has been marked improvement in intermittent claudication and rest pain. Ischaemic ulcers have healed and the progression of gangrene has stopped. If carried out with the complete understanding of the anatomy of the omental vascular arcade, the results of omentopexy are gratifying, thus avoiding amputation and conserving the limb.

Patrones arteriográficos en la enfermedad de Buerger

La tromboangeítis obliterante o enfermedad de Buerger ha sido reconocida como entidad patológica desde hace más de 80 años. Afecta primordialmente las arterias de miembros inferiores. Dentro de los criterios utilizados para su diagnóstico se incluyen los cambios arteriográficos en pacientes con enfermedad de Buerger. Informamos nuestra experiencia en estudios arteriográficos en pacientes con enfermedad de Buerger en los últimos cinco años. Llamamos la atención sobre la alta frecuencia de lesiones proximales a la arteria poplítea (57 por ciento). Los signos arteriográficos más frecuentes encontrados fueron tortuosidad de los vasos (57 por ciento), adelgazamiento progresivo del lumen (50 por ciento), alternancia de la lesión (50 por ciento), adelgazamiento abrupto (50 por ciento), siendo menos frecuentes los signos clásicamente descritos para la enfermedad como lo son: colaterales en tirabuzón (29 por ciento), signo de Martorrell (21 por ciento), corrugado de la pared del vaso (14 por ciento) e imagen en raíz de árbol (7 por ciento). Todas las arteriografías mostraron múltiples hallazgos de compromiso vascular, entre 3 y 7 de los signos descritos para la enfermedad

Segmented colon ischemia associated with thromboangiitis obliterans

A necrose isquêmica do colo associada à tromboangeíte obliterante é rara e grave, com uma mortalidade elevada. A tromboangeíte abliterante ocorre em pacientes jovens e as manifestaçöes digestivas, raras nesta moléstia, ocorrem posteriormente aos acometimentos dos membros. Relata-se caso de um paciente com necrose segmentar isquêmica de colo com tromboangeite obliterante