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.

Severe Mesenteric Hemorrhagic Infarction by Superior Mesenteric Arterial Occlusion in a Patient with Buerger's Disease / 대한소화기학회지

No abstract available.

Autologous bone marrow-derived stem cell therapy in patients with Buerger's disease

Patients suffering from Thrornboangiitis Obliterans [TAO] or Buerger's disease have endothelial cell dysfunction and the severity of the disease lies in the need for amputation in more than a quarter of all sufferers. The aim of present study was to determine whether granulocyte colony-stimulating factor mobilized autologous bone-marrow derived mononuclear cells transplantation improves endothelial dysfunction in these patients. Circulating mononuclear cells containing endothelial progenitor cells were obtained from patients following bone-marrow mobilization with granulocyte colony stimulating factor. Mononuclear cells and CD34+ cells were enumerated prior to intramuscular injection into the affected limbs. In this pilot study, autologous bone-marrow derived mononuclear cell therapy collected from peripheral blood following granulocytes colony stimulating factor [G-CSF] mobilization was effective, safe and resulted in sustained clinical results for patients with severe peripheral occlusive arterial diseases

Infarto del miocardio coincidente con la enfermedad de Buerger (Tromboangeítis obliterante): Informe de un caso / Concurrence of myocardial infarction with Buerger's disease (Thromboangiitis obliterans): Report of a case

Antecedentes: Se han publicado pocos casos en que coincide la enfermedad de Buerger con la afección visceral, entre ellas la cardíaca, caracterizada por obstrucción arterial coronaria. Relatamos el caso de un paciente de 56 años, con enfermedad de Buerger coincidente con cardiopatía isquémica: infarto extenso anterior del miocardio, trombosis y obstrucción de la arteria coronaria descendente anterior mostrada en la coronariografía. Presentación del caso: Varón de 56 años, fumador compulsivo desde los 15 años de edad, obeso, normotenso arterial, portador de enfermedad de Buerger desde hace 15 años, sin síntomas ni signos de enfermedades reumatológicas y exámenes inmunológicos negativos, con antecedentes de infarto antiguo del miocardio anterior extenso, secundario a enfermedad difusa de la arteria coronaria descendente. Actualmente presenta síntomas y signos de cardiopatía isquémica e imágenes angiográficas sugestivas de trombos en el interior de la arteria coronaria descendente anterior, de aspecto grácil (imagen en tirabuzón), severa y difusamente obstruida (80%) y mal lecho vascular distal. Discusión: La asociación causal entre la enfermedad de Buerger y la enfermedad coronaria es rara y difícil de probar en ausencia de exámenes inmunológicos e histopatológicos y los datos aportados por la arteriografía coronaria no prueban que ambas entidades tengan origen común. Sin embargo, la imagen angiográfica de la arteria coronaria grácil, en tirabuzón y con trombos intraluminales sugiere extensión de la tromboangeítis hacia el lecho arterial coronario. Conclusión: Es rara la coincidencia de la enfermedad de Buerger con arteriopatía coronaria. La extensión coronaria es difícil de demostrar solamente con los datos coronariográficos; sin embargo, hay datos en la literatura médica que sugieren que la obstrucción arterial coronaria, en estos casos, es el resultado de la extensión de la vasculopatía.

Background: Few cases of Buerger's disease concurring with visceral disorders, i.e., cardiac disease characterized by coronary obstruction have been published. We report the case of a 56 years old patient, with Buerger's disease concurring with ischemic heart disease: extensive anterior myocardial infarction, thrombosis, and obstruction of the left anterior descending coronary artery, evidenced through coronariography. Description of the case: Male patient, 56 years old, severe smoker since the age of 15, obese, normal blood pressure, carrier of Buerger's disease for 15 years, without symptoms or signs of rheumatic disorders, and negative immunological tests, with antecedents of an old extensive myocardial infarction secondary to diffuse disease of the left anterior descending artery. At present, with symptoms and signs of ischemic cardiopathy and angiographic images suggesting the presence of thrombi inside the anterior descending coronary artery, of gracile aspect (corkscrew image), severe and diffusely obstructed (80%), and poor distal vascular bed. Discussion: Causal association between Buerger's disease and coronary disease is rare and difficult to demonstrate in the absence of immunological and histopathological tests. Data provided by coronariography do not evidence a common origin for both diseases. However, the angiographic image of the gracile coronary artery, corkscrew-shaped, and with intraluminal thrombi suggests dissemination of the thromboangiitis to the coronary arterial bed. Conclusion: The concurrence of Buerger's disease with coronary pathology is rare. Coronary dissemination is difficult to demonstrate with only coronariography data; however, there are data in the medical literature suggesting that coronary obstruction, in these cases, results from the dissemination of the vasculopathy.

Study of myopathies by histological and histochemical methods with special reference to staining for desmin expression.

An attempt was made to study the histological and histochemical changes as well as immunohistochemical changes in desmin expression occurring in four types of clinical myopathies e.g. Chronic ischaemic myopathy due to Buerger's disease (Group I), Carcinomatous myopathy (Group II), Metabolic myopathy (Group III) and Muscular dystrophy (Group IV). The number of cases studied were 16 cases, 15 cases, 4 cases and 5 cases respectively. The study revealed: (i) a combination of normal, degenerated, necrotic and regenerating fibres in different proportions in all the four groups having maximum number of degenerated fibres in Group I and Group IV, relatively more number of regenerating fibres in groups III and absence of necrotic fibres in Group I. (ii) Altered tinctorial property in most of the fibres indicating degenerated and regenerating fibres in all the groups with Masson's trichrome staining against inconstant staining with PTAH appear to be a good indicator for myopathy. (iii) The Desmin expression was week and irregular in most of the cases with most of the fibres probably due to reduction of desmin content probably indicating degenerated fibres, appear to be a good indicator for myopathy. (iv) Chronic ischaemic myopathy showed close resemblance with muscular dystrophy though no typical or distinct distinguishing feature could be identified in these four groups.

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