References
[1]. Chan K. P. and Hodgsen A. R. (1970) physiologic leg lengthening clinical orthopedics and related research 68,55
[2]. Castle M. E. (1971) epiphyseal stimulation, journal of bone and joint surgery 53a, 326
[3]. Jenkins D. H. R. Heng D. H. F., and Hodgeson A. R. (1975), Stimulation of bone growth by periosteal stripping. A clinical Study. Journal of bone and joint surgery 57 b, 482
[4] Van Damme H, De Leval L, Creemers E, Limet R,: Thrombangitis obliterans (Buerger's disease): still a limb threatening disease. Acta Chir Belg 1997 Oct97:5 229-36[
[5]. Humphries A. W. Dewolfe V. G. Young J. R.: Evaluation of the Natural history and the results of treatment in occlusive arteriosclerosis involving the lower extremities in 1850 patients in Wesolowski, sa and dennis, c (eds): fundamentals of vascular grafting :mcgraw hill, new york1963, p 423.
[6]. Juevgens J. L., Spittell J. A.,jr and Fairbairn J.F. ii Peripheral vascular diseases, ed 5, wb saunders, Philadelphia, 1980
[7]. Illizarov G.A. transosseous osteosynthesis, springer-verlag 1992, osteogenesis andhematopoiesis p 279.
[8] Dewolfe V. G.: Assessment of the circulation in occlusive arterial diseases of the lower extrimities, mod conc cardiovascular dis 45:91 1976.
[9]. Dewolfe, V. G.and Beren E. G.: Arteriosclerosis obliterans in the lower extrimities. Correlation of clinical and angiographic findings. In gifford r.w. jr.(ed) : peripheral vascular disease.Cardiovascular clinics vol. 3 #1, f.a.devis,philadelphia 1971 p 65
[10]. Majno, G. : inflammation and infection, historical highlights , Majno G.,and Cotron R.S. (eds): current topics in inflammation and infection. Baltimore, williams and wilkins co., 1982 p 1
[11]. Cohneim J., lectures in general pathology, translated by Mckee A.D.from the second german edition, vol.1,london new Sydenham Society 1889
[12]. Zweifach B. W.: vascular events in the inflammatory process in Zweifach B. W., Grant l. and Mccluskey R. T.(eds). The inflammatory process 2nd ed. Vol.II, New York Academic Press 1973 pp 3-40.
Recent Medline search on the available study of TAO PubMed Nucleotide Protein Genome Structure PopSet Search PubMed Protein Nucleotide Structure Genome PopSet for Limits Preview/Index History Clipboard About Entrez Entrez PubMed Overview Help | FAQ New/Noteworthy PubMed Services Journal Browser MeSH Browser Single Citation Matcher Batch Citation Matcher Clinical Queries Old PubMed Related Resources Order Documents Grateful Med Consumer Health Clinical Alerts ClinicalTrials.gov Privacy Policy Summary Brief Abstract Citation MEDLINE ASN.1 LinkOut Related Articles Protein Links Nucleotide Links Popset Links Structure Links Genome Links Show: 5 10 20 50 100 200 500 Items 1-101 of 101 One page. 1: Int J Cardiol 1998 Oct 1;66 Suppl 1:S273-80; discussion S281 Related Articles, Books, LinkOut The change in concept and surgical treatment on Buerger's disease--personal experience and review. Nakajima N First Department of Surgery, Faculty of Medicine, Chiba University, Japan. Buerger's disease was originally described by Leo Buerger in 1908 as thromboangitis obliterance and has been considered as one of the most intractable vasculitis syndromes in our country. This lesion is popularly seen in male young generation with a background history of heavy smoking. Buerger's disease in Japan has been frequently seen in our practice; however, it is noted that there have been certain definitive changes in relation to number of patients, clinical manifestation as well as course of treatment in particular in surgical treatment. Firstly, the number of patients who visited at outpatient clinic as well as to admit hospital has been sharply declined. Secondly, the number of surgical treatments of Buerger's disease have also decreased. The sympathectomy, mainly lumbal sympathectomy, which was maintained at about 15 to 20% of the number of patients admitted, was virtually abolished from the practice and mainly converted to the medical and pharmacological treatment by prostaglandin. The reliability of pharmacological sympathectomy is one of the other reasons which contributed to the shift of treatment. It is also our impression that the severity of the disease itself has been changed, in other words, we do not frequently see very severely ill patients. As far as surgery is concerned the important modality in the treatment for the advanced lesion of Buerger's disease is mainly confined in small arteries with multisegmental occlusion. As a consequence, the surgical reconstructive procedures are technically difficult and long term patency rate is considered to be low. As far as our experience is concerned, it is noted that the number of bypass surgery was most frequently seen at below trifurcation segment of knee joint; in other words, peripheral, distal type bypass was the most popular, followed by above knee segment. The reconstructive surgery at femoral region was least frequently seen. On the other hand, the patency rate of bypass graft was higher in the proximal segment in comparison to the distal segment. Although the number of arterial reconstructive procedures has been definitively declined, as was seen in sympathectomy surgery. It is difficult to predict accurately what kind of factors are affecting or contributing to the change in concept in Buerger's disease as well as the course of treatment, it is suggested that the environmental factors may playing a major role for the modification of disease process. Publication Types: Review Review, tutorial PMID: 9951830, UI: 99135301 -------------------------------------------------------------------------------- 2: Cardiovasc Surg 1993 Aug;1(4):377-80 Related Articles, Books, LinkOut Surgical treatment of Buerger's disease: experience with 216 patients. Sayin A, Bozkurt AK, Tuzun H, Vural FS, Erdog G, Ozer M Department of Thoracic and Cardiovascular Surgery, Istanbul University Cerrahpasa Medical Faculty, Turkey. Buerger's disease (thromboangiitis obliterans) is a rare peripheral vascular disease that usually affects young male smokers. It is characterized by multiple occlusions distal to the knee and elbow. Although rarely encountered in this condition, major arterial occlusions can be corrected by arterial revascularization. The hospital records of 216 patients (214 men and 2 women) with Buerger's disease were reviewed retrospectively, 142 (66%) between 1 and 120 (mean(s.d.) 72.8(24)) months after diagnosis. Of these patients 21 had had an arterial revascularization; 183 lumbar and 20 thoracic sympathectomies had been performed. In 30 of the patients a total of 29 minor and four major amputations had been performed. In appropriate cases arterial reconstruction provides better healing of ischaemic lesions. Although vasomotor tone is usually normalized in 2 weeks to 6 months after sympathectomy, the temporary increase in blood flow is often sufficient to heal ischaemic lesions during this period. PMID: 8076063, UI: 94356529 -------------------------------------------------------------------------------- 3: J Cardiovasc Surg (Torino) 1980 Jan-Feb;21(1):77-84 Related Articles, Books, LinkOut Surgical treatment of Buerger's disease. Shionoya S, Ban I, Nakata Y, Matsubara J, Hirai M, Kawai S Forty of 266 patients with Buerger's disease underwent 47 vascular reconstructions: bypass in 38, thromboendarterectomy in 7 and replacement in 2. Indications for arterial reconstruction were ulceration or gangrene in 60%, claudication in 33.3% and rest pain in 6.7%. In a follow-up from 6 months to 8 years and 7 months, the overall patency rate was 24% in bypass, 0% in thromboendarterectomy and 100% in replacement. One hundred nine of the 266 patients underwent sympathetic denervation: lumbar in 92 (bilateral in 19) and thoracic in 17. In the course of 11 years follow-up study, 23 cases required amputation of the extremity. A good initial result gradually gave way to recurrence unless the patients discontinued smoking. The most important factor which decides natural history of Buerger's disease is smoking. PMID: 7358786, UI: 80137693 -------------------------------------------------------------------------------- 4: Br J Surg 1976 Nov;63(11):841-6 Related Articles, Books, LinkOut Vascular reconstruction in Buerger's disease. Shionoya S, Ban I, Nakata Y, Matsubara J, Hirai M In 23 of 148 patients with Buerger's disease, it was possible to undertake 27 arterial reconstructive procedures: bypass in 22 and thrombo-endarterectomy in 5. In a follow-up of 10 months to 8 years, the overall patency rate was 26 per cent. The long term patency rate of bypass grafting was good in obstruction of main vessels, but unsatisfactory with multiple occlusions. Bypass grafting was preferred to thromboendarterectomy. To obtain long term patency of revascularaized segments, complete abstinence from tobacco is absolutely essential. The preparatory manoeuvres for antogenous venous graft should be as atraumatic as possible. A functional diagnosis is indispensable when considering operative indications and for follow-up study of patients with peripheral arterial occlusive disease. PMID: 1000177, UI: 77066204 -------------------------------------------------------------------------------- 5: Eur J Vasc Endovasc Surg 1997 Feb;13(2):186-92 Related Articles, Books, LinkOut Role of infrainguinal bypass in Buerger's disease: an eighteen-year experience. Sasajima T, Kubo Y, Inaba M, Goh K, Azuma N First Department of Surgery, Asahikawa Medical College, Japan. OBJECTIVES: The role of bypass to the distal arteries for patients with Buerger's disease (thromboangiitis or TAO) remains controversial because of the high incidence of graft failure. We retrospectively reviewed the results of 71 bypasses to evaluate their efficacy. MATERIALS AND METHODS: We performed 71 autogenous vein bypasses in 61 patients with TAO. Of the patients, 97% were heavy smokers. The indications for surgery were claudication in 41%, and ischaemic ulcer or gangrene in 59%. Of the bypasses 85% were to the crural arteries or to the arteries below the ankle. The grafts used were 53 single saphenous veins, and 18 venovenous composite grafts. RESULTS: There were 38 graft failures, the main causes including anastomosis to a diseased artery, disease progression (which occurred in smokers after surgery), and vein graft stenosis. Of 38, 10 were restored to patency by revision surgery. Primary and secondary patency rates were 48.8% and 62.5% at 5 years, and 43.0% and 56.3% at 10 years, respectively. The patency rates of the postoperative non-smoking group was significantly higher than that of the smoking group (66.8% vs. 34.7%, p < 0.05). Thirty-six patients (59%) had successful revascularisation and returned to full-time work. However, of 28 with secondary failure, 11 underwent amputation, while 14 had persistent disabling claudication. CONCLUSION: Bypass to the distal arteries is an effective treatment for TAO patients, and the long-term patency is quite satisfactory as long as patients stop smoking. Comments: Comment in: Eur J Vasc Endovasc Surg 1997 Oct;14(4):322 PMID: 9091153, UI: 97226314 -------------------------------------------------------------------------------- 6: Nippon Geka Gakkai Zasshi 1993 Jul;94(7):751-4 Related Articles, Books, LinkOut [Results of arterial reconstruction in Buerger's disease]. [Article in Japanese] Izumi Y, Sasajima T, Inaba M, Morimoto N, Goh K, Kubo Y First Department of Surgery, Asashikawa Medical College, Japan. One hundred and eight bypass operations for Buerger's disease were performed between November 1976 and August 1990. The bypass procedures, prostheses, cumulative patency rate and the influence of smoking on the results were discussed. Five-year cumulative patency rate of Aorto-femoral bypass was 88.2%. Aorto-femoral bypass should be always indicated as a standard procedure for the iliac lesion in Buerger's disease, because the patency rate was very low in aorto-iliac bypass group or ilio-femoral bypass group. Five-year cumulative patency rate of infrainguinal bypass using autogenous vein was 64.8%, and that in the patients who quit cigarette smoking was as high as to 73.3%. We should use autogenous vein as much as possible for infraiguinal bypass and discontinuance of cigarette smoking is considered to be one of the important factors to improve the patency rate in Buerger's disease. PMID: 8361475, UI: 93368568 -------------------------------------------------------------------------------- 7: J Mal Vasc 1989;14(1):47-9 Related Articles, Books, LinkOut [Surgical aspects in the therapy of Buerger's disease]. [Article in French] Aschieri F, Capaldi E, De Simone F, Capaldi G Service de Chirurgie vasculaire, Ospedale Mauriziano, Turin, Italie. Buerger's disease is generally not improved by reconstructive surgery. This one may be expected to succeed only on the atherosclerotic occlusions which eventually occur. Surgical treatment is therefore essentially based on the lumbar sympathectomy, both for trophic purpose as well as for pain relief. Criteria for unavoidable amputations are then exposed. PMID: 2921570, UI: 89156692 -------------------------------------------------------------------------------- 8: Surgery 1998 Sep;124(3):498-502 Related Articles, Books, LinkOut Decrease in prevalence of Buerger's disease in Japan. Matsushita M, Nishikimi N, Sakurai T, Nimura Y First Department of Surgery, Nagoya University School of Medicine, Japan. BACKGROUND: Buerger's disease is a peripheral arterial occlusive disease that is becoming rare in Western countries but is more common in Asia. Whether it is a specific disease entity remains controversial. This study was undertaken to investigate changes in the prevalence and characteristics of Buerger's disease at a major institution in Japan. METHODS: Patients with Buerger's disease admitted to Nagoya University Hospital between January 1985 and December 1996 were studied retrospectively. Buerger's disease was diagnosed on admission according to Shionoya's clinical criteria. RESULTS: A total of 105 patients with Buerger's disease were evaluated on 126 admissions; 58 were new patients who were admitted for initial treatment, and 47 patients were experiencing a worsening of Buerger's disease and had a history of prior treatment. Forty-six new patients were admitted between 1985 and 1989, but only 12 new patients were admitted between 1990 and 1996 (9 3/ yr vs 2 2/ yr, p = 0.0003). Between 1985 and 1989, 44 patients were admitted because of disease exacerbation, whereas only 24 such admissions occurred between 1990 and 1996 (9 3/ yr vs 3 yr, p = 0.0137). The number of admissions for atherosclerotic peripheral vascular disease did not change significantly in that period. Of the 105 patients, the majority (96%) were men; mean age at the time of disease onset was 36 8 years. The chief complaint on admission was gangrene/ulcer in 64%, rest pain in 13%, foot claudication in 6%, calf claudication in 6%, and other in 10%. CONCLUSION: The prevalence of Buerger's disease appears to be decreasing at our institution in Japan. Its clinical characteristics have not changed. A similar decrease in prevalence appears to have occurred in Western countries. PMID: 9736901, UI: 98408108 -------------------------------------------------------------------------------- 9: Orv Hetil 1965 Sep 26;106(39):1830-3 Related Articles, Books, LinkOut [Surgical treatment of Buerger's disease]. [Article in Hungarian] Sztankay C, Goracz G PMID: 5834045, UI: 66016211 -------------------------------------------------------------------------------- 10: Przegl Lek 1972;29(4):458-62 Related Articles, Books, LinkOut [Selection of the method of surgical treatment in patients with the so called Buerger disease]. [Article in Polish] Bak S PMID: 5033124, UI: 72205464 -------------------------------------------------------------------------------- 11: World J Surg 1984 Jun;8(3):423-4 Related Articles, Books, LinkOut The definition of Buerger's disease. Adar R, Papa MZ Publication Types: Letter PMID: 6464497, UI: 84276286 -------------------------------------------------------------------------------- 12: Am J Surg 1987 Jul;154(1):123-9 Related Articles, Books, LinkOut Buerger's disease in the modern era. Mills JL, Taylor LM Jr, Porter JM In an effort to determine the current incidence and clinical course of Buerger's disease, we reviewed the records of over 700 patients with small artery disease who were evaluated at Oregon Health Sciences University during a 15 year period. We identified 26 patients who met rigid criteria for the diagnosis of Buerger's disease. An analysis of the management and extended follow-up of these patients has indicated that Buerger's disease, although rare, is a real clinical entity which can be diagnosed objectively. The relatively high rate of limb loss (31 percent of patients) documents the virulence of Buerger's disease involving the lower extremities. No major upper extremity amputations were required, and no patient lost further tissue after cessation of smoking. These findings and the low mortality rate in this study stand in contrast to many previous reports and may aid in establishing the current natural history of Buerger's disease in North America. PMID: 3605510, UI: 87268324 -------------------------------------------------------------------------------- 13: Nursing 1976 Sep;6(9):17, 19 Related Articles, Books, LinkOut Buerger's disease. Upcavage AT PMID: 1049014, UI: 77012123 -------------------------------------------------------------------------------- 14: J Indian Med Assoc 1978 Oct 16;71(8):199-202 Related Articles, Books, LinkOut Buerger's disease versus adrenalectomy and sympathectomy. Naik RS, Tripathi BP, Vaidya RC, Sao VK PMID: 748471, UI: 79152489 -------------------------------------------------------------------------------- 15: Ann Vasc Surg 1994 May;8(3):248-57 Related Articles, Books, LinkOut Plantar or dorsalis pedis artery bypass in Buerger's disease. Sasajima T, Kubo Y, Izumi Y, Inaba M, Goh K First Department of Surgery, Asahikawa Medical College, Japan. The peripheral type of Buerger's disease is unresponsive to conservative therapy when accompanied by multisegmental occlusion at the level of the ankle. Between November 1983 and April 1993, we performed 15 bypasses below the ankle for this type of thromboangiitis obliterans in 13 patients (mean age 45.7 years), including four females. Ten patients had intractable toe ulcers with severe pain, and five had foot-threatening ischemia or disabling foot claudication. Eleven patients were heavy smokers, two were passive smokers, and six had a history of sympathectomy. All patients had occlusion of the three main crural arteries or both of the tibial arteries at the ankle. Of the 15 bypasses, 10 were to the medial or lateral plantar arteries, two were to the common plantar artery, and three were to the dorsalis pedis artery. There were three early and three late graft failures. The causes of early graft failure were thrombosis at the site of cross-clamping, anastomosis to a diseased segment, and arterial spasm. The three late failures (> 3 months) were due to disease progression in patients who continued to smoke, whereas all grafts remained patent and functioned well in patients who stopped smoking. Because patients with thromboangiitis obliterans are relatively young and active, early healing of ulcers and restoration of normal limb function are important objectives in their treatment. Bypass to the foot arteries can provide an excellent outcome, although special techniques and postoperative cessation of smoking are essential for success. PMID: 8043358, UI: 94318382 -------------------------------------------------------------------------------- 16: Vasa 1986;15(2):174-9 Related Articles, Books, LinkOut [Arterial reconstructions in Buerger disease]. [Article in German] Largiader J, Schneider E, Brunner U, Bollinger A PMID: 3727768, UI: 86264019 -------------------------------------------------------------------------------- 17: Int J Cardiol 1998 Oct 1;66 Suppl 1:S243-5; discussion S247 Related Articles, Books, LinkOut Diagnostic criteria of Buerger's disease. Shionoya S SL Medical Group, Nagoya, Japan. After many changes, Buerger's disease stands as an independent clinicopathologic entity, but a better understanding of Buerger's disease has been impeded by the lack of unanimous diagnostic criteria of the disease. Since specificity of Buerger's disease is characterized by peripheral ischemia of an inflammatory nature and with a self-limiting course, diagnostic criteria of Buerger's disease should be discussed from clinical point of view. Our clinical criteria for the diagnosis of Buerger's disease are: (1) smoking history; (2) onset before the age of 50 years; (3) infrapopliteal arterial occlusions; (4) either upper limb involvement or phlebitis migrans; and (5) absence of atherosclerotic risk factors other than smoking. Confident clinical diagnosis of Buerger's disease may be made only when all five requirements have been fulfilled. A set of strict and well-defined clinical diagnostic criteria is essential for any study of Buerger's disease to ensure the homogeneity of the selected patient population for valid comparisons. PMID: 9951826, UI: 99135297 -------------------------------------------------------------------------------- 18: Surg Gynecol Obstet 1982 Feb;154(2):238-40 Related Articles, Books, LinkOut Experience with popliteal-infrapopliteal bypass grafting. Feldman AJ, Nevonen M, Berguer R Ten patients with severe infrapopliteal arterial occlusive disease at the time of our evaluation underwent 11 vein bypasses confined to the below-knee segment. Previous reconstruction of the femoral and proximal popliteal arteries had been done in three limbs and were all patent at the time we performed the distal bypass. Eight limbs had minimal or no occlusive disease in the femoral and popliteal arteries and had no previous proximal arterial reconstruction. Tissue loss or rest pain was the indication for operation in all patients. There were no deaths. Two grafts occluded within 24 hours. Seven have remained patent from two to 48 months. Arteriography, including complete evaluation of the pedal vasculature, is needed to select these patients properly. Vein bypass grafts limited to the below-knee segment may be a useful alternative in selected patients to the more traditional femoroinfrapopliteal bypass grafts. PMID: 7058486, UI: 82129607 -------------------------------------------------------------------------------- 19: Int J Cardiol 1998 Oct 1;66 Suppl 1:S267-72 Related Articles, Books, LinkOut Buerger's disease at the 'San Juan De Dios' Hospital, Santa Fe De Bogota, Colombia. Jimenez-Paredes CA, Canas-Davila CA, Sanchez A, Restrepo JF, Pena M, Iglesias-Gamarra A Internal Medicine Department, Medical School, National University of Colombia, San Juan de Dios Hospital, Santa Fe de Bogota. OBJECTIVES: To know the clinical characteristics in the presentation of Buerger's disease in San Juan de Dios Hospital, Bogota, Colombia, between 1986 and 1996, and compare them with a previous series from the same Hospital and another reported in international literature; To determine the changes in the form of appearance of the disease. METHODS: We reviewed the clinical information of 22 patients with diagnosis of Buerger's disease, observed between 1986 and 1993, and we added the information of the clinical histories of eight other patients with equal diagnosis, observed between 1994 and 1996 in our Unit. RESULTS: We observed 30 patients: 28 men (93%) and two women (7%), with a ratio M:F of 14:1, with an average age of 39 years (range from 18 to 52 years). Sixty percent were younger than 40 years and only the 10% were older than 50 years. The most frequent reasons for consultation were: pain in rest in the affected extremity, gangrene and ulceration in more than 50%. Raynaud's phenomenon in 30%, and the related surgical history in 40%. The pedal pulse was the most compromised followed by popliteal, poster or tibial and femoral. We did not observe the presence of thrombophlebitis. Eighty percent showed compromise of more than one extremity. All of them were active smokers. Three patients showed IgG anticardiolipine antibodies at high level. CONCLUSIONS: The clinical characteristics are similar to those reported, we find also a reduction of the disease diagnosis. It calls to our attention that no thrombophlebitis was found in the present series and the less compromise of the upper extremities with a frequent femoral compromise. All this points toward a change in the natural history of the disease. PMID: 9951829, UI: 99135300 -------------------------------------------------------------------------------- 20: Aust N Z J Surg 1997 May;67(5):264-9 Related Articles, Books, LinkOut Buerger's disease in Hong Kong: a review of 89 cases. Lau H, Cheng SW Department of Surgery, University of Hong Kong, Queen Mary Hospital, Hong Kong. BACKGROUND: A retrospective analysis of 103 case records from 1978 to 1996 with a provisional diagnosis of Buerger's disease was undertaken at the Department of Surgery, University of Hong Kong, Queen Mary Hospital. The aim of the study was to elucidate the clinical course and evaluate the results of surgical intervention of Buerger's disease in Hong Kong Chinese people. METHODS: Fourteen patients were subsequently excluded from the study because of inability of fulfil our diagnostic criteria. Data on clinical presentation, investigations, indications and results of surgical intervention were reviewed. Sympathectomies and arterial reconstructions were performed on 42 and four patients, respectively, for critical ischaemia or rest pain. Outcome was analysed with respect to the rate of ulcer healing, pattern of recurrence and limb loss. RESULTS: The patients were all young male heavy smokers with a mean age of 36.5 years. The majority of patients (80%) presented with ischaemic ulceration or gangrene. Vascular reconstruction was undertaken in four patients and satisfactory long-term results were obtained in three patients. Sympathectomy was able to relieve symptoms in 87% of operated patients and ischaemic ulceration healed in 2.6 (mean) 1.7 (SD) months after the operation. If the patient continued to smoke, surgical intervention did not exempt the patient from a relapse or amputation. CONCLUSION: Sympathectomy provides short-term pain relief and promotes ulcer healing in patients with Buerger's disease but carries no long-term benefit. Complete abstinence from smoking is the only means of arresting the progression of the disease. PMID: 9152156, UI: 97296687 -------------------------------------------------------------------------------- 21: Nippon Geka Gakkai Zasshi 1989 Jul;90(7):1110-6 Related Articles, Books, LinkOut [Indication of femorotibial and femoroperoneal bypass for Buerger's disease]. [Article in Japanese] Yano T, Shionoya S, Ikezawa T, Sakurai T, Miyauchi M, Mukaiyama H, Nishikimi N First Department of Surgery, Nagoya University School of Medicine, Japan. Infrapopliteal bypass with autogenous vein graft was performed in twenty-three patients of thromboangiitis obliterans (Buerger's Disease) during the past 8 years. The outflow vessel of the graft had the direct connection with the pedal arch in 3 cases. In 20 cases the graft was anastomosed to the solitary tibial or peroneal segment, in which the occlusive lesion existed between the outflow vessel and pedal arch, or otherwise, the pedal arch was not opacified in the arteriogram. The length of the solitary tibial or peroneal segment of the successful cases ranged from 11.5 cm to 29.0 cm. The cumulative patency rates of the 23 bypass grafts at 3 months, 1 year, 3 years and 5 years were 86.7%, 77.3%, 77.3%, 77.3% respectively. This result is comparable to those of other authors. When the solitary tibial or peroneal artery is found out and is longer than 12 cm in the arteriogram of Buerger's Disease, we are going to perform bypass surgery to the vessel. If the foot is already necrotic, the amputation should be carried out several days or several weeks after the successful reconstructive surgery. PMID: 2796977, UI: 90014752 -------------------------------------------------------------------------------- 22: J Indian Med Assoc 1974 Apr 16;62(8):277-81 Related Articles, Books, LinkOut Buerger's disease. Agarwal SL, Trehon OP, Srivastava VK PMID: 4412258, UI: 75007599 -------------------------------------------------------------------------------- 23: S Afr Med J 1986 Dec 20;70(13):803-5 Related Articles, Books, LinkOut Buerger's disease or Buerger's syndrome? An analysis of 12 cases. Scharf GM, van Wyk FA, Cloete GN, Rautenbach BK Controversy continues over the clinical concept of Buerger's disease. Although clinical and radiological criteria exist to prove the diagnosis and most clinicians acknowledge this disease, there is the question of possible cases of Buerger's disease where the criteria cannot be met. Should these cases be referred to as Buerger's syndrome? In order to elucidate this question, we analysed 12 recent cases (1% of all our cases of vascular disease). In 6 cases (50%) the clinical and diagnostic criteria of Buerger's disease were met fully; in 4 (32%) the clinical picture favoured Buerger's syndrome; in another 2 patients the clinical picture was that of Buerger's syndrome but the arteriograms showed signs of atheroma. Eight of the 12 patients underwent sympathectomy. One patient, considered to have visceral and cerebral involvement, died. PMID: 3798265, UI: 87094501 -------------------------------------------------------------------------------- 24: Angiology 1975 Nov;26(10):713-6 Related Articles, Books, LinkOut Buerger's syndrome. Herman BE All cases diagnosed as Buerger's disease at The Mount Sinai Hospital from 1933-1963 have been reviewed. A large majority were found to have well-known vascular problems other than what we now consider as Buerger's disease. Only two specimens from 33 amputations had the characteristic histologic findings that Buerger described. It is suggested that the terminology Buerger's disease be replaced by Buerger's syndrome. In 1908, while at The Mount Sinai Hospital, Dr. Leo Buerger described a clinical entity with its histologic counterpart that soon became known as "Buerger's disease." The clinical picture was essentially that of arterial insufficiency, mainly in the lower extremities, in a young, Jewish, adult male who smoked. It was frequently associated with a migrating thrombophlebitis. The histologic picture was not as clearly defined but was stated to differ from arteriosclerosis in that normal vessel was found proximal and distal to the lesion, canalization of the occlusive lesion occurred, capillary ingrowth was present in the media, and there was an absence of elastic tissue in the organizing process. It should be noted that most of Buerger's specimens consisted of veins removed during an episode of acute thrombophlebitis. He specifically stated that only in the early stages of the disease, when phlebitis was the main finding, could the lesion be separated from the various stages of arteriosclerosis. In recent years, doubt has been cast on the existence of the clinical or pathological picture described by Buerger. Accordingly, it was thought advisable to review the case records and pathologic specimens of patients discharged from The Mount Sinai Hospital with the diagnosis of Buerger's disease over a recent 30-year period. PMID: 1053580, UI: 87268757 -------------------------------------------------------------------------------- 25: Aust N Z J Surg 1978 Aug;48(4):382-7 Related Articles, Books, LinkOut Buerger's disease--a review of 105 patients. Wong J, Lam ST, Ong GB One hundred and five cases (101 males and four females) of Buerger's disease occurring in Hong Kong have been reviewed. In the foot the digits affected were predominantly the big, second and little toes, whereas in the hand the index and middle fingers were most commonly involved. There was no selective involvement of the left or right side in the upper or lower extremities. The majority of patients were operated on and had amputation, sympathectomy, or both procedures performed. Major lower limb amputation was carried out in 22.6% of patients with lower limb involvement. Reconstructive arterial surgery was possible in only four patients, and early failure of grafts in three patients resulted in major amputation. PMID: 282868, UI: 79103083 -------------------------------------------------------------------------------- 26: Int Angiol 1999 Mar;18(1):58-64 Related Articles, Books, LinkOut Factors affecting the long-term outcome of Buerger's disease (thromboangiitis obliterans). Shigematsu H, Shigematsu K Department of Surgery, Faculty of Medicine, The University of Tokyo, Japan. BACKGROUND: Although the age at onset in patients with Buerger's disease is relatively young, the life expectancy has been seldom reported in detail. The aim of this study is to study long-term results of Buerger's disease and factors affecting the ultimate outcome. METHODS: From 1965 to 1980, 682 patients with Buerger's disease were treated in our outpatient department. We studied their long-term status, including concomitant diseases, and the disease progression by mail. RESULTS: Of the 287 mail responders, 266 were male and 21 were female, with a mean age of 60 years. One hundred and fifty-five of these patients are currently suffering from clinical symptoms. Forty-eight patients underwent minor amputation and 30 and major amputation. Forty-six patients underwent sympathectomy, and only 17 bypass reconstruction. Although there was no significant difference in the continuation of symptoms between current smokers and ex-smokers, the amputation rate was higher in current smokers and continuous smoking is closely related to both minor and major amputations after sympathectomy and to minor amputations after drug therapy. Arteriosclerotic diseases were recognized in 57 patients, and gastroduodenal ulcer in 44. Thirty-three patients had died. Among 14 who died of neoplasm, three died of esophageal cancer and lung cancer, respectively, which were closely related to smoking. CONCLUSIONS: The natural history of the limbs in patients with Buerger's disease is not completely discouraging, and in order to obtain a favourable outcome for patients with Buerger's disease we recommend complete smoking cessation with drug-therapy and surveillance for neoplasm, especially of the upper gastrointestinal tract and lung. PMID: 10392482, UI: 99319653 -------------------------------------------------------------------------------- 27: J Cardiovasc Surg (Torino) 1973 Jan-Feb;14(1):37-9 Related Articles, Books, LinkOut Surgical considerations on the terminology aand treatment of the so-called Buerger's disease. Vollmar J PMID: 4690975, UI: 73135783 -------------------------------------------------------------------------------- 28: Acta Chir Belg 1997 Oct;97(5):229-36 Related Articles, Books, LinkOut Thrombangiitis obliterans (Buerger's disease): still a limb threatening disease. Van Damme H, De Leval L, Creemers E, Limet R Department of Cardiovascular Surgery, University Hospital of Liege (CHU Sart-Tilman), Belgium. A series of 29 well-documented and properly analysed patients with thrombangiitis obliterans (Buerger's disease) is presented. The diagnosis of Buerger's disease was based on following criteria: smoking history, onset before the age of 50 years, infrapopliteal arterial occlusive disease, either upper limb involvement or phlebitis migrans, absence of atherosclerotic risk factors other than smoking. In the last 10 years (1986-1996), we identified 29 patients who met these rigid criteria. There were 24 men and 5 women, aged 32.4 years at the moment of the disease first clinical symptom. The cumulative tobacco use averaged 16 pack-years for each patient. The initial symptom was limited gangrene of a toe (n = 9) or a finger (n = 2), foot claudication (n = 6), calf claudication (n = 3), rest pain (n = 3), migratory superficial phlebitis (n = 4), and Raynaud phenomenon (n = 2). Angiography and/or Doppler ultrasound revealed digital, pedal and calf artery involvement in all patients, with proximal extension in ten patients (femoropopliteal in ten, including three cases with external iliac artery involvement). Seven patients had also evidence of upper limb involvement. Histologic proof was available in only seven patients. Only nine patients completely stopped smoking. Treatment was exclusively medical in five cases. Twenty-four underwent sympathectomy (20 at lumbar, and four at thoracic level), with good immediate result in 16. In 11 patients a vascular reconstruction was done (eight femorocrural and three iliofemoral bypasses), with a patency rate of only 36% at two years. Amputation was required in 16 patients (a mean of 2.7 amputations per patient) at one or more levels: toe (n = 19), forefoot (n = 5), below knee (n = 8), above knee (n = 2), finger (n = 3). Two patients ended up with bilateral leg amputation. Overall, 23% (7/30) of the patients required major leg amputation during the course of the disease. Disease progression was moderately related to continued tobacco use. Buerger's disease still entails considerable risk of major amputation. Complete abstinence from tobacco use is crucial to expect stabilization of the process. However, in advanced stages of the disease and despite cessation of smoking recurrent episodes of ischaemia or tissue loss are not excluded. PMID: 9394964, UI: 98056982 -------------------------------------------------------------------------------- 29: Cardiovasc Surg 1993 Jun;1(3):207-14 Related Articles, Books, LinkOut Buerger's disease: diagnosis and management. Shionoya S SL Medical Group, Nagoya, Japan. Buerger's disease is characterized by peripheral arterial occlusion of the extremities in young male smokers. In true Buerger's disease lesions rarely occur in the proximal arteries. The incidence of the disease is low in Europe and the USA, but its management remains a major problem for vascular surgeons in Asia where its incidence is higher. Aetiology of the disease remains unknown, but there is a clear relationship between tobacco abuse and its occurrence or recurrence; complete cessation of smoking renders the disease benign. Despite a high incidence of digital gangrene or ulceration, a functional foot or hand can generally be preserved because of the good healing potential of the trophic lesions. Specificity of the disease is characterized by peripheral ischaemia of an inflammatory nature and with a self-limiting course. The clinical term Buerger's disease is preferred to the pathological term thromboangiitis obliterans. Diagnosis is based on knowledge of the natural history of the disease, which aids prognosis and the decision to undertake surgical or conservative management. Treatment of Buerger's disease should avoid premature, possibly unnecessary, surgery. The condition is no longer a disease of misconceptions; its diagnosis and management should be based on a clear understanding of the pathophysiology. Publication Types: Review Review, tutorial PMID: 8076031, UI: 94356495 -------------------------------------------------------------------------------- 30: Angiology 1982 Jun;33(6):375-84 Related Articles, Books, LinkOut Pattern of arterial occlusion in Buerger's disease. Shionoya S, Hirai M, Kawai S, Seko T, Ban I The pattern of arterial occlusion in Buerger's disease was analyzed by simultaneous bilateral femoral arteriography in 210 limbs of 105 patients with Buerger's disease. In 55 limbs of 42 patients, the femoropopliteal segment was affected in addition to the infrapopliteal arterial obstructive lesion. The pattern of crural arterial occlusion was similar in about 40% of both the patients with femoropopliteal occlusion and the patients with crural occlusion. Toes were ulcerated in 4 of 58 limbs with continuous arterial flow, and ulceration occurred in 86 of 152 limbs with a discontinuous flow. The rate of occurrence of bilateral trophic lesion in the group with an arteriographically similar occlusion pattern was not significantly higher than that in the group with a different pattern. The pattern of arterial occlusion in Buerger's disease seemed to be fixed mainly within 1 year after the onset of symptoms, and the skip-lesion in the main artery was favorable to proximal progression of the disease. PMID: 7091768, UI: 82228772 -------------------------------------------------------------------------------- 31: Eur J Vasc Surg 1991 Jun;5(3):362 Related Articles, Books, LinkOut Buerger's disease. Friedman SG Publication Types: Comment Letter Comments: Comment on: Eur J Vasc Surg 1990 Dec;4(6):575-81 PMID: 1864403, UI: 91323569 -------------------------------------------------------------------------------- 32: Ann R Coll Surg Engl 1992 Mar;74(2):115-7; discussion 118 Related Articles, Books, LinkOut Buerger's disease and cigarette smoking in Bangladesh. Grove WJ, Stansby GP University Department of Surgery, Royal Free Hospital and School of Medicine, London. Buerger's disease is rare in the West but common in parts of Asia and the Middle East. A total of 39 patients with Buerger's disease were investigated in the setting of a hospital in Bangladesh. All but one were male and the mean age at onset of symptoms was 34 years. All but two were current smokers with a mean duration of smoking history of 17 years before the onset of symptoms. No other risk factors were identified. The majority of patients had ulceration or gangrene at presentation, and all but one had palpable femoral pulses. Vascular reconstruction was not possible in this institution and the main treatment options adopted were antibiotics, analgesia, chemical sympathectomy and amputation. Comments: Comment in: Ann R Coll Surg Engl 1992 Nov;74(6):436-7 PMID: 1567129, UI: 92231442 -------------------------------------------------------------------------------- 33: Eur J Vasc Endovasc Surg 1997 Oct;14(4):322 Related Articles, Books, LinkOut Buerger's disease. Adar R, Papa MZ Publication Types: Comment Letter Comments: Comment on: Eur J Vasc Endovasc Surg 1997 Feb;13(2):186-92 PMID: 9366803, UI: 98033598 -------------------------------------------------------------------------------- 34: Nippon Rinsho 1994 Aug;52(8):2192-202 Related Articles, Books, LinkOut [Surgical treatment of intractable vasculitis syndromes--with special reference to Buerger disease, Takayasu arteritis, and so-called inflammatory abdominal aortic aneurysm]. [Article in Japanese] Tada Y Second Department of Surgery, Yamanashi Medical University. Since the incidence of inflammatory arterial disease has been higher in Japan, its surgical treatment has been one of the main themes of vascular surgery from its beginning in this country. Buerger disease has been the main cause of chronic occlusive arterial disease before the middle of 1970s. and many patients suffered from intractable ischemic leg ulcer with severe pain. Reconstructive surgery, however, has been so much limited that number of the candidates for bypass surgery were around 10% of the patients, because of distal nature of the disease. We have developed a new technique in distal bypass surgery named as Esmarch's rubber bandage method, which was intended to minimize surgical injury to the host artery, and the results of its application to Buerger disease is very encouraging, and we have confirmed that this technique enables a bypass to the collateral arteries and muscular branches in place of the diseased tibio-peroneal artery. We expect this technique will clear a new avenue to surgical treatment of Buerger disease with limb threatening ischemia. In Takayasu's arteritis, the carotid reconstruction was popular between the late 1950s and 1960s and, at the same time atypical coarctation, renovascular hypertension, and aneurysm, along with their combined lesion became the objects of vascular surgery. This expansion of surgical indication contributed to the improvement of the prognosis and rehabilitation of the patients. Long term function of the reconstruction has been also confirmed. On the other hand, several problems emerged with the widespread application of vascular reconstruction which were peculiar to the disease state. Among them, the most important problems were neurological complications due to sudden increase in the intracranial blood pressure after carotid reconstruction, and anastomotic aneurysm as the delayed complication affecting eventual outcome which are inherent to the inflammation and extensive destruction of the medial component in this disease. A new method to prevent the postoperative neurological complications is discussed in this report. To improve the long term survival, meticulous observation of postoperative course is essential in Takayasu's arteritis. Recently, abdominal aortic aneurysms showing the peculiar gross appearance and clinical presentation have become the subject of discussion as inflammatory abdominal aortic aneurysm because of remarkable thickening of the aneurysmal wall and a severe inflammatory change, and some difficulties of its surgical treatment have been stressed in the most of the reports. The recent researches offered the conclusion that etiology of the aneurysm is not inflammation, but inflammatory reaction during formation of atherosclerotic aneurysm. Publication Types: Review Review, tutorial PMID: 7933611, UI: 95019201 -------------------------------------------------------------------------------- 35: Br J Radiol 1973 Feb;46(542):110-4 Related Articles, Books, LinkOut Aortic involvement in Buerger's disease. Gilkes R, Dow J PMID: 4686810, UI: 73096687 -------------------------------------------------------------------------------- 36: Int Angiol 1991 Oct-Dec;10(4):247-9 Related Articles, Books, LinkOut A case of Buerger's disease with pathology confirmation. Balas P, Faliakou E, Papalambros E First Department of Surgery, Athens University, Medical School, Laikon Hospital, Athens, Greece. PMID: 1797935, UI: 92185312 -------------------------------------------------------------------------------- 37: J Cardiovasc Surg (Torino) 1978 Jan-Feb;19(1):69-76 Related Articles, Books, LinkOut Involvement of the iliac artery in Buerger's disease (pathogenesis and arterial reconstruction). Shionoya S, Ban I, Nakata Y, Matsubara J, Hirai M, Kawai S Out of 216 patients with Buerger's disease, 14 showed the involvement of the iliac artery in addition to the occlusive lesion in the leg arteries. It occurred within 2 to 8 years after the onset of symptom. The obliterative lesion of the iliac artery might owe its cause to a direct proximal progression of thromboangitis obliterans of the femoral artery or to a skip progression of the disease. The skip lesion of the iliac artery might be due to an ascending progress of the thromboangiitic lesion in the branch arteries of the iliac artery. The indication for arterial reconstruction in the case with the involvement of the iliac artery depends on run-off in the deep femoral artery. Out of the 14 cases, 2 underwent thromboendarterectomy with autogenous vein patch grafting of the external iliac artery and 6 underwent bypass grafting, but their long-term follow-up result was poor. PMID: 627595, UI: 78109637 -------------------------------------------------------------------------------- 38: Presse Med 1993 Jun 5;22(20):945-8 Related Articles, Books, LinkOut [Buerger disease, clinical and prognostic aspects. 83 cases]. [Article in French] Dehaine-Bamberger N, Amar R, Touboul C, Emmerich J, Fiessinger JN Centre Claude Bernard de Recherche sur les Maladies vasculaires peripheriques, Hopital Broussais, Paris. A retrospective analysis of 83 records of patients with Buerger's disease is presented. There were 71 men and 12 (14.5 percent) women. Compared with men, women with Buerger's disease had a significantly more frequent vasomotor disorder, but they had less trophic disorders and a lower risk of amputation. After a 42-month follow-up, it appeared that tobacco plays a major role in the prognosis: patients who continued to smoke had significantly more numerous acute episodes than those who ceased smoking. The degree of intoxication is an element of prognosis, but good medical management contributes to reduction in the number of major amputations: only 5 patients (6 percent), all male, had a leg (4 cases) or a thigh (1 case) amputated. PMID: 8367418, UI: 93376665 -------------------------------------------------------------------------------- 39: Surgery 1981 Mar;89(3):296-303 Related Articles, Books Femoropopliteal bypass to the isolated popliteal segment: is polytetrafluoroethylene graft acceptable? Veith FJ, Gupta SK, Daly VD In a series of 148 polytetrafluoroethylene femoropopliteal bypasses performed for limb salvage, 33-month life-table cumulative patency rates for grafts inserted into an isolated popliteal artery segment (91% 5%) were not significantly different from those inserted into a popliteal segment with angiographically better runoff (78% 5%). Similarly, below-knee reconstructions had 3-year patency rates (86% 6%) that were not significantly different from those for bypasses inserted into the popliteal artery above the knee (79% 6%). One clear disadvantage of the isolated popliteal artery segment as a site for distal insertion of the bypass was the increased incidence of limb loss despite a patent reconstruction. This was particularly frequent in diabetics with extensive foot gangrene or infection and could be avoided by a secondary extension of the bypass to a patent distal leg or foot artery. PMID: 7466617, UI: 81126779 -------------------------------------------------------------------------------- 40: Int J Cardiol 1998 Oct 1;66 Suppl 1:S257-63; discussion S265 Related Articles, Books, LinkOut Buerger's disease with intestinal involvement. Iwai T First Department of Surgery, School of Medicine, Tokyo Medical and Dental University, Japan. iwai.srg1@med.tmd.ac.jp Here I describe three cases of intestinal Buerger's disease and review previously reported cases. All patients had involvement of the extremities and clinical manifestations of Buerger's disease. Occlusive changes in intestinal arteries also occurred, in both the presence and absence of abdominal symptoms. Intestinal Buerger's disease may be asymptomatic, acute, or chronic, and treatment varies according to the type of disease. Publication Types: Review Review of reported cases PMID: 9951828, UI: 99135299 -------------------------------------------------------------------------------- 41: J Cardiovasc Surg (Torino) 1998 Feb;39(1):19-23 Related Articles, Books, LinkOut Tibioperoneal bypass for popliteal arterial occlusion. Sugawara Y, Sato O, Miyata T, Kimura H, Namba T, Makuuchi M II Department of Surgery, Faculty of Medicine, University of Tokyo, Japan. OBJECTIVE: To clarify the clinical features of chronic arterial occlusive disease in which the main lesion occurs in the popliteal artery (OPA). EXPERIMENTAL DESIGN: This was a retrospective study with a follow-up of 1 to 163 months. SETTING: A department of surgery in a university hospital. PATIENTS: Fifty-six patient who underwent tibioperoneal bypasses: 31 patients with OPA, and 25 with an extensive occlusive lesion from the femoral to popliteal artery (OFPA). INTERVENTION: All bypasses were performed using reversed saphenous veins under tourniquet ischemia. MEASUREMENTS: The background of the patients and the surgical results, including long-term patency and postoperative arteriographic findings. RESULTS: Buerger's disease occurred most commonly in the OPA group (49%) and arteriosclerosis obliterans occurred most commonly in the OFPA group (64%). The 3-year primary and secondary cumulative patency rates of the grafts for OPA were 72% and 85% respectively, and were comparable with those of OFPA. Arteriographic analyses carried out in the follow-up period revealed no occlusive progression in the inflow artery. CONCLUSIONS: Popliteal-distal bypass is a reliable procedure in selected patients with OPA. PMID: 9537530, UI: 98196879 -------------------------------------------------------------------------------- 42: Nippon Geka Hokan 1976 May 1;45(3):227-32 Related Articles, Books, LinkOut [Reconstruction of the occluded popliteal artery--popliteal artery entrapment syndrome and Buerger's disease]. [Article in Japanese] Iwahashi K, Murata S, Yasunaga T, Takahashi H, Gorokawa M PMID: 988808, UI: 77043844 -------------------------------------------------------------------------------- 43: Br J Surg 1979 Feb;66(2):124-8 Related Articles, Books, LinkOut Arterial obstruction of the upper limb in Buerger's disease: its incidence and primary lesion. Hirai M, Shionoya S In the present study, the incidence of upper extremity involvement and the primary lesion of the arm in Buerger's disease were investigated with special regard to arteriographic findings in the upper limb. Of 34 patients with Buerger's disease admitted to our hospital during the 12-month period from March 1977 to February 1978, in 31 cases (91 per cent) the existence of arterial obstruction of the upper limb was confirmed. From the results of arteriographic study in 78 arms, the primary lesion of Buerger's disease appears to develop most frequently in the digital arteries. However, it is possible for the disease to develop independently in the arteries of the hand, or in the radial or ulnar artery. Although the aetiology of Buerger's disease is not definitely known, it is suggested that repeated blunt injury to the hand or fingers is involved in the evolution of the disease as well as in the appearance of symptoms. PMID: 420983, UI: 79125247 -------------------------------------------------------------------------------- 44: Int Angiol 1997 Dec;16(4):239-44 Related Articles, Books, LinkOut Clinical and morphological aspects of Buerger's disease. Majewski W, Marszalek A, Staniszewiski R, Majewski P, Zapalski S, Biczysko W Department of General and Vascular Surgery, University School of Medical Sciences, Poznan, Poland. BACKGROUND: Thirty-five patients with TAO and 35 with ASO have been studied. To determine differences between these two arterial diseases, we used clinical criteria, arteriographic and morphological methods. The peripheral (below the bifurcation of the popliteal artery) angiographic changes were found in TAO with 94% sensitivity, 94% specificity and with 96% of positive predictive value. Other clinical diagnostic criteria for differential diagnosis had a lower value (they had high sensitivity and low specificity or low sensitivity and high specificity). RESULTS: The histologic studies confirmed the clinical diagnoses of Buerger's disease in 92,9% cases. The pathologic findings in TAO and ASO were different. CONCLUSIONS: Our investigations proved that the characteristics of Buerger's disease include the development of changes not only in small and medium size arteries or veins, but also in microcirculation. PMID: 9543220, UI: 98202221 -------------------------------------------------------------------------------- 45: Semin Vasc Surg 1997 Mar;10(1):8-16 Related Articles, Books, LinkOut Limitations of percutaneous transluminal angioplasty with stenting for femoropopliteal arterial occlusive disease. Gray BH, Olin JW Department of Vascular Medicine, Cleveland Clinic Foundation, OH 44195, USA. PURPOSE: To review the results of intravascular stents used to treat superficial femoral artery (SFA) occlusive disease and to assist in patient selection for this procedure. METHODS AND RESULTS: We evaluated 55 patients who underwent balloon angioplasty and stenting of SFA long-segment disease and compared the results with those in the current literature. In our patient group, the SFA mean lesion length was 16.5 cm with the resting ankle-brachial index of 0.48 0.19. Hemodynamic improvement to an ABI of 0.71 0.23 (P = .001) and clinical benefit (56%) were maintained at 13.8 months. Primary and secondary patency rates were 22% and 46%, respectively, at 12 months. The literature reports patency rates of 29% to 81% primarily and 43% to 96% secondarily. However, the mean lesion length in these reports varied from 3.7 cm to 13.5 cm, and most of these patients had claudication (50% to 92%). Other variable factors determining long-term success may include the number and type of stent, artery occlusion versus stenoses, presence of diabetes mellitus, and smoking status. CONCLUSIONS: Stenting of short-segment SFA disease remains patent more frequently than for long-segment disease, and may be applicable in patients with disabling claudication or critical limb ischemia. Surgical revascularization is preferred for long-segment disease, with stenting reserved for patients with limb-threatening ischemia and no surgical alternative. PMID: 9068071, UI: 97220909 -------------------------------------------------------------------------------- 46: Angiology 1982 Apr;33(4):239-50 Related Articles, Books, LinkOut Buerger's disease revisited. Welling RE TAO is a distinct, pathologic, and clinical disease process. Its diagnosis can be arrived at with a reasonable degree of certainty by the clinical history, angiographic findings, and pathology. Tobacco plays a very important part in the etiology of the disease process and must be completely avoided in any form for successful treatment. Four-extremity arteriography is recommended to assess the present nature of the disease and for a comparison at a later date. Direct arterial surgery is seldom feasible because of the distal and segmental nature of TAO. Sympathectomy can be helpful if combined with elimination of tobacco and quiescence of the disease. Meticulous local therapy to the ischemic tissue with control of infection and precise amputation if necessary is extremely important. PMID: 7073017, UI: 82180158 -------------------------------------------------------------------------------- 47: Med Arh 1974 Jul-Aug;28(4):369-75 Related Articles, Books, LinkOut [Experimental-surgical aspect of Buerger's disease and its hyperpyretic therapy. Clinical experiences with partial salvage amputation of the lower limbs on a demarcation zone in Buerger's disease]. [Article in Serbo-Croatian (Cyrillic)] Kaufer L, Grin E, Prcic M, Boskovic S, Atijas A, Stipancevic L PMID: 4444348, UI: 75080986 -------------------------------------------------------------------------------- 48: South Med J 1976 Apr;69(4):393-5 Related Articles, Books, LinkOut Femoral tibial bypass grafts. Harrington OB, Crosby VG, Wolf RY, Reichart BA, Hines L The results of 53 femoral to tibial artery bypass grafts have been reviewed. All were carried out in an attempt to salvage severely ischemic extremities which resulted from arteriosclerotic occlusive disease involving the femoral, popliteal, and tibial arterial systems as demonstrated by arteriography. Most grafts were done with autogenous vein; however, composite grafts comprised of a Dacron prosthesis and an autogenous vein and homologous veins were used in several patients. The initial salvage rate in these pregangrenous extremities was 74%. Fifty-two percent of the grafts remain patent at this writing, a period of 56 months in some instances. This study indicates that most patients with a severely ischemic extremity are candidates for revascularization and should have angiographic studies before amputation is considered. PMID: 1265491, UI: 76178147 -------------------------------------------------------------------------------- 49: INTERNATIONAL JOURNAL OF ANGIOLOGY 1998 May;7(3):188-90 Related Articles, Books, LinkOut The Role of Polytetrafluoroethylene Graft Material in Buerger's Disease. Bozkurt AK, Tuzun H, Sayin AG, Karaozbek Y, Koksal C, Ozer M Department of Thoracic and Cardiovascular Surgery, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey [Record supplied by publisher] The early and long-term results of polytetrafluoroethylene (PTFE) grafts in different anatomical locations were evaluated in 14 patients with Buerger's disease (thromboangiitis obliterans). During a 10-year period, 2160 patients with peripheral vascular disease were treated and, in 258, the diagnosis of Buerger's disease was made. Fourteen of these 258 patients underwent revascularization with PTFE grafts. In a follow-up period, up to 8 years patency rates were as follows: aorto/ilofemoral bypass 80%, femoropopliteal bypass 40%, femorocrural bypass 50% with a cumulative patency rate of 57.1%, and limb salvage rate of 88.9%. Because of the diverse nature and small number of the operations, the numerical results are not amenable to statistical analysis, but 88.9% limb salvage rate is satisfying in Buerger's disease. To the best of our knowledge, this is the first report on the use of PTFE grafts in Buerger's disease and it validates limb salvage even below the inguinal ligament. PMID: 9585447 -------------------------------------------------------------------------------- 50: J Cardiovasc Surg (Torino) 1980 Mar-Apr;21(2):143-8 Related Articles, Books, LinkOut Review of 210 autogenous vein by-pass operations. Stephens RB, MacGowan WA This is a retrospective review, using the life table method, of 210 vein by-pass operations. Sixtythree percent of the operations were performed for limb salvage. Eightyeight percent of the operations were performed with the distal anastomosis below the knee joint. The longerm patency rates for those grafts with good run-off was significantly better (p = .036) than for those with poor run-off and the addition of a lumbar sympathectomy was found not to significantly alter the longterm patency rates. Re-operation for graft failure in the first 448 hours after operation was found to be worthwhile procedure giving a cumulative patency rate of 59.9% at five years. A five year cumulative patency rate of 57% is reported and autogenous vein bypass is considered a worthwhile procedure for limb salvage and some selected claudicants with femoro-popliteal arterial disease. PMID: 7364856, UI: 80160121 -------------------------------------------------------------------------------- 51: Clin Radiol 1982 Mar;33(2):235-40 Related Articles, Books, LinkOut Buerger's disease (thromboangiitis obliterans): an analysis of the arteriograms of 119 cases. Suzuki S, Mine H, Umehara I, Yoshida T, Okada Y One hundred and forty-four lower extremity arteriograms of 119 patients with Buerger's disease have been analysed. The 'corkscrew' appearance of collateral circulation was seen in 27.1% of 144 limbs affected by thromboangiitis obliterans, but in only 3.2% of 63 limbs affected by arteriosclerosis obliterans. We believe that the corkscrew vessel is highly characteristic of Buerger's disease and represents dilated vasa vasorum of the occluded main artery. The appearance of corkscrew vessels extending from the arterial occlusion sites to the periphery of the feet without opacification of the main pedal arteries indicated a poor prognosis. PMID: 7067357, UI: 82163537 -------------------------------------------------------------------------------- 52: J Cardiovasc Surg (Torino) 1982 Mar-Apr;23(2):105-8 Related Articles, Books, LinkOut Arterial insufficiency of the upper extremity with special reference to Takayasu's arteritis and Buerger's disease. Mishima Y The occlusive arterial lesions of the upper extremity in Takayasu's arteritis is estimated in 72.3% in the left and in 45.6% in the right subclavian arteries, respectively. Buerger's disease also involves the arteries distal to the elbow and the digital arteries in about 22% of total cases. In Takayasu's arteritis, the surgical treatment for the upper extremity ischemia is rarely indicated, except for the cases with aneurysm, because the occlusive lesion involves exclusively the aorta and its branches, and severe ischemia of the upper digital arteries in Buerger's disease frequently causes severe ischemic symptoms of hand and fingers, such as rest pain, trophic changes and tissue loss. Therefore, the surgical treatment, including upper thoracic sympathectomy and amputation, is mandatory in some cases. PMID: 6123515, UI: 82214150 -------------------------------------------------------------------------------- 53: Geka Chiryo 1966 Aug;15(2):180-92 Related Articles, Books, LinkOut [Raynaud's disease and Buerger's disease]. [Article in Japanese] Tsunekawa K, Hirooka, Yamamoto K, Mori K, Inami K PMID: 6014053, UI: 68045396 -------------------------------------------------------------------------------- 54: Minerva Chir 1968 Oct 31;23(20):1061-5 Related Articles, Books, LinkOut [Treatment of Buerger's disease]. [Article in Italian] Battezzati M, Belardi P, Becchi G PMID: 5759995, UI: 71275593 -------------------------------------------------------------------------------- 55: Am J Med 1986 May;80(5):1003-5 Related Articles, Books, LinkOut Buerger's disease in a young woman. Leavitt RY, Bressler P, Fauci AS Buerger's disease or thromboangiitis obliterans is characterized by peripheral arterial occlusions in young male cigarette smokers. It is rarely considered in the differential diagnosis of vascular disease in women, although there have been several well-documented cases in the literature. This report presents a young woman with both angiographic and histopathologic evidence for Buerger's disease who was initially treated with daily corticosteroids for presumed vasculitis. This case emphasizes the fact that Buerger's disease can present in a fashion similar to both vasculitis and collagen vascular disease. PMID: 3706362, UI: 86212288 -------------------------------------------------------------------------------- 56: J Vasc Interv Radiol 1990 Nov;1(1):57-61 Related Articles, Books, LinkOut Short vein grafts in limb-saving arterial reconstructions. Veith FJ, Gupta SK, Wengerter KR, Farrell E Division of Vascular Surgery, Montefiore Medical Center-Albert Einstein College of Medicine, New York, NY 10467. In the management of limb-threatening infrainguinal arteriosclerosis, the short vein graft is a feature of distal-origin bypass procedures from the superficial femoral and popliteal arteries to more distal arteries. These procedures, which can only be performed in selected patients, have patency rates equivalent to those of comparable bypasses from the common femoral artery. Other advantages include the increased availability of the shorter vein graft segment that is required. Two newer operations that use short vein grafts are tibio-tibial bypasses and bypasses to isolated segments of infrapopliteal arteries. The authors' initial experience with these two procedures includes encouraging patency and limb salvage rates for periods up to 2 years in patients for whom there was no other therapeutic option short of amputation. PMID: 2134036, UI: 92182472 -------------------------------------------------------------------------------- 57: Rev Med Interne 1998 Jan;19(1):34-43 Related Articles, Books, LinkOut [Buerger's disease or thromboangiitis obliterans]. [Article in French] Reny JL, Cabane J Service de medecine interne, hopital Saint-Antoine, Paris, France. PURPOSE: To review clinical data, pathophysiology and treatment of thromboangiitis (Buerger's disease). DATA SYNTHESIS: Buerger's disease or thromboangiitis obliterans (TAO) is an obliterative vascular disease that affects medium and small sized arteries as well as superficial veins. Young males and smokers are preferentially afflicted with the disease. TAO accounts for 0.5 to 5% of occlusive vascular disease. Though TAO has a world-wide distribution, it can be found with greater prevalence in Eastern Europe, the Mid-East, Asia, and Southeast Asia. Women account for 10 to 20% of the patients and 5 to 10% are more than 60-years-old. Approximately 95% are smokers and disease activity is strongly associated with the use of tobacco. The pathogenesis is poorly understood and most hypotheses are controversial. There is no specific marker of the disease and the diagnosis is based on clinical and angiographic criteria. The disease spontaneously leads to tissue loss and major amputations. This can generally be avoided by discontinuing smoking. Induced hypervolemia and prostacyclins are effective treatments of critical limb ischemia in TAO. CONCLUSION: If pathophysiology is still poorly understood, spontaneous evolution can be avoided by stopping tobacco and prostacyclin. Publication Types: Review Review, tutorial PMID: 9775113, UI: 98448239 -------------------------------------------------------------------------------- 58: Cardiovasc Surg 1993 Jun;1(3):215-9 Related Articles, Books, LinkOut Arteritis: experience in Jeddah, Saudi Arabia. al Zahrani HA Department of Surgery, King Abdulaziz University, Jeddah, Saudi Arabia. Inflammation of the arteries is a difficult condition to diagnose and treat. Eighteen consecutive patients (16 men, two women) with arteritis treated in the vascular surgery department of King Fahad Hospital, Jeddah, Saudi Arabia, over a period of 3 years were reviewed to define the local pattern of the disease. The mean age of the group was 29.2 (range 18-50) years. Buerger's disease was diagnosed in 11 patients and considered to be the most common type of arteritis. Other types of arteritis identified were: non-specific (four patients), infective (one), irradiation (one) and vasculitis secondary to scleroderma (one). The most common finding was severe lower-limb ischaemia from infrapopliteal occlusion. Arteriography carried out in 16 patients showed either occlusion or stenosis of the affected artery. In one patient an associated renal aneurysm was detected. All patients were advised to stop smoking and unilateral or bilateral lumbar sympathectomy undertaken in those with Buerger's disease. By adopting this policy limb salvage was achieved in nine of the 11 patients with Buerger's disease. In addition to these measures, corticosteroids were prescribed for selected cases of arteritis. PMID: 8076032, UI: 94356496 -------------------------------------------------------------------------------- 59: Zentralbl Chir 1982;107(8):440-7 Related Articles, Books, LinkOut [Pro and contra profundaplasty]. [Article in German] Vollmar JF, Heyden B, Voss EU The profundaplasty has recently advanced to a widely used surgical approach for revascularisation of the lower extremities, both for claudication and limb salvage. The effectiveness of this simple time saving procedure depends on a critical selection of patients and the use of an improved surgical technique. Main prerequisites are the simultaneous aorto-iliac inflow repair, using thromboendarterectomy or bypass, the patency of the so-called "receptor segment" of the popliteal artery and a sufficient run- off in the distal arterial tree. An additional lumbar sympathectomy has proved as a protective adjunct which results in an additional increase of flow in the restored deep femoral artery. In combined occlusive lesions of the aorto-iliac and femoro-popliteal segment the late results of a proximal inflow repair in combination with profundaplasty and lumbar sympathectomy are significantly superior to the total repair of both arterial segments. A profundaplasty is contraindicated if this artery is seriously diseased or in the presence of total occlusion of the popliteal artery (receptor segment) and of more than two main arteries below the knee. This is the place where long distal grafts are still justified for limb salvage. In over 80% of patients with arterial occlusive disease of the leg arteries the profundaplasty (with or without aorto-iliac inflow-repair) has proved as an effective alternative to time-consuming extensive arterial reconstructions with equivocal outcome. PMID: 7102151, UI: 82252755 -------------------------------------------------------------------------------- 60: Arch Surg 1983 Apr;118(4):472-6 Related Articles, Books Early experience with popliteal to infrapopliteal bypass for limb salvage. Schuler JJ, Flanigan DP, Williams LR, Ryan TJ, Castronuovo JJ In an attempt to improve graft patency and limb salvage in patients with isolated tibial vessel and/or popliteal-tibial vessel occlusive disease, bypass grafts from the popliteal or distal superficial femoral artery to infrapopliteal arteries were used in patients requiring bypass for limb salvage. During a 2 1/2-year period, 23 patients with patent axial vessels and hemodynamically normal inflow to the level of the knee underwent such bypasses. Cumulative graft patency and limb salvage rates at 31 months were 84% and 70%, respectively. Five of the six patients who required below-knee amputation did so because of progressive gangrene in the presence of a patent bypass. Short bypasses between the popliteal and infrapopliteal arteries can significantly contribute to limb salvage in patients with tibial vessel occlusive disease and may be particularly useful in patients with saphenous veins too short for longer bypasses. PMID: 6830437, UI: 83152224 -------------------------------------------------------------------------------- 61: S Afr Med J 1984 Nov 3;66(18):701-2 Related Articles, Books, LinkOut Buerger's disease. A case report and review of the literature. du Toit DF, Maritz J, Klompje J, Laker L, Groenewald JH A case of thrombo-angiitis obliterans (Buerger's disease) in a 30-year-old man is reported. Irremediable gangrene necessitated amputation of both legs, and distal amputation of the fingers and thumb of the right hand. PMID: 6495115, UI: 85040753 -------------------------------------------------------------------------------- 62: Surgery 1974 May;75(5):695-700 Related Articles, Books, LinkOut Diagnosis, pathology, and treatment of Buerger's disease. Shionoya S, Ban I, Nakata Y, Matsubara J, Shinjo K PMID: 4824428, UI: 74149095 -------------------------------------------------------------------------------- 63: Angiology 1972 Dec;23(11):668-87 Related Articles, Books, LinkOut The entity of Buerger's disease. Inada K, Kattsumura T PMID: 4657729, UI: 73149936 -------------------------------------------------------------------------------- 64: Chung Hua Wai Ko Tsa Chih 1985 Aug;23(8):471-3, 509 Related Articles, Books, LinkOut [Angiographic findings of femoral artery and its collaterals in Buerger's diseases]. [Article in Chinese] Tan HY, Hu JM, Hou RG PMID: 4092543, UI: 86135081 -------------------------------------------------------------------------------- 65: Cas Lek Cesk 1985 May 24;124(21):648-50 Related Articles, Books, LinkOut [Buerger's disease in women]. [Article in Czech] Krcilek A, PokornyJ, Hergetova H PMID: 4016857, UI: 85254712 -------------------------------------------------------------------------------- 66: Vasa 1990;19(1):47-53 Related Articles, Books, LinkOut [Surgical treatment of peripheral arterial occlusive disease in diabetes mellitus; in situ saphenous vein bypass versus reverse bypass procedure--a retrospective study]. [Article in German] Sandmann W, Kniemeyer HW, Jalschak R, Grabitz K Abteilung fur Gefasschirurgie und Nierentransplantation, Universitat Dusseldorf. The scope of reconstructive possibilities in the treatment of patients with peripheral occlusive arterial disease and diabetes mellitus had been increased thanks to further development of surgical methods. It is especially the in-situ-bypass procedure which has opened the path to new anastomotic sites at the level of the foot. Our own experience with 86 bypass procedures in 84 patients has given us an early patency rate of 82% in non-diabetic arterial occlusions and of 80% in diabetics. The amputation rate was 7% in the former group, 14% in diabetics with atherosclerotic occlusion. In comparison to the reversed bypass the early graft occlusion rate fell from 26% to 14% and the amputation rate from 13 to 9%. Thus, operative mortality fell from 9 to 2.4%, although the average age had risen from 61 to 67 years and the percentage of stage IV disease from 38% to 51%. Patency of bypass procedures with anastomosis to distal calf arteries was 83% und rose to 92% if the distal anastomosis was to arteries in the vicinity of the ankle. The caveat in this study is the fact that an apparent superiority of the in-situ-bypass is based on retrospective comparison of somewhat widely separated historical groups. PMID: 2343656, UI: 90261297 -------------------------------------------------------------------------------- 67: Vasa 1990;19(1):40-6 Related Articles, Books, LinkOut [Results of therapy following lumbar sympathectomy. A retrospective study over the course of 10 years]. [Article in German] Schutter FW, Sandmann W, Ashrafnia S Abteilung fur Gefasschirurgie und Nierentransplantation, Universitat Dusseldorf. In a retrospective study we report about 142 patients who had 159 lumbar sympathectomies from 1975-1985. The angiological status was evaluated with a clinical examination or a questionnaire. In 96% we saw the clinical stages III and IV. The clinic lethality was 3.5%. Besides the sympathectomies 62 reconstructive procedures were necessary which were performed mostly before the sympathectomy. The higher the occlusion resp. stenosis the worse the prognosis after sympathectomy. A postoperative abstinence of smoking improves the prognosis. The amputation rate was 35.8% including minor amputations (n = 20) and loss of the extremity (n = 37). The high number of minor amputations shows that the sympathectomy is an appropriate procedure to shift the amputation to the periphery. The older the patient the higher the amputation rate. The analysis of the clinical examination or the questionnaire shows that a third of the patients has a long-term profit from the sympathectomy. PMID: 2343655, UI: 90261296 -------------------------------------------------------------------------------- 68: Vestn Khir Im I I Grek 1977 Mar;118(3):11-5 Related Articles, Books, LinkOut [Plastic surgery of the arteries of the lower limbs with autologous vein and its association with lumbar sympathectomy]. [Article in Russian] Kurbangaleev SM, Katsadze MA, Tone RV In surgical treatment of patients with arterial occulsion of the lower limbs an autovein was employed as a transplant in 66 patients. In 22 patients reconstructive operation was performed after preliminary lumbar sympathectomy. Restored patency of the operated segment with restoration of foot artery pulsation was noted in 53 patients. Late results were followed up for 1--6 years in 32 patients. Major blood flow was maintained in 24 patients (75%). Other conditions being equal, reconstructive operations yield better results, if lumbar sympathectomy was preliminary performed. PMID: 878175, UI: 77217310 -------------------------------------------------------------------------------- 69: Wien Klin Wochenschr 1979 Feb 2;91(3):89-94 Related Articles, Books, LinkOut [Femoro-crural reconstruction in preference to amputation]. [Article in German] Deutsch M, Bardach G, Kaliman J, Staudacher M, Weisskirchner R 22 cases of arterial occlusion below the branching of the popliteal artery and 1 case of traumatic subtotal amputation of the calf were revascularized by autogenous femoro-crural vein bypasses. All patients had pain at rest and/or gangrene. So far, with an average bypass patency of 15 months in two of three equal parts of the operated legs, the decision to try reconstruction instead to amputate has met with successful results. The operative technique is described in detail and the speical problems of this group of patients and the particular difficulties of this technically sophisticated bypass procedure are discussed. PMID: 425528, UI: 79140617 -------------------------------------------------------------------------------- 70: Chirurgie 1980 Nov;106(9):687-98 Related Articles, Books, LinkOut [Leo Buerger's disease: a review and report on 23 cases]. [Article in French] Benyahia B, Ammar F, Sefrioui AL, Sefrioui AR, Bensouda M PMID: 7471989, UI: 81137357 -------------------------------------------------------------------------------- 71: J Cardiovasc Surg (Torino) 1982 May-Jun;23(3):235-42 Related Articles, Books, LinkOut Critical evaluation of limb salvage concept and indication for infrapopliteal reconstructive surgery. Biasi G, Miani S, Tealdi D, Tanganelli P, Sforza V, Weber G, Marconato R, Ruberti U A large number of surgical procedures aimed at revascularizing the popliteal and infrapopliteal arteries has been reported in patients affected by rest pain or gangrene of the extremities as well as intermittent claudication. In consideration of the high incidence of early and late unsuccessful results following this type of surgery as reported in the literature, we believe that peripheral reconstructions should be restricted to those patients presenting a clinical picture of such severity that major amputation is unavoidable in the short run. In these patients our choice of the appropriate surgical procedure is strictly related to the patency or not of the popliteal artery. The role of the above knee femoropopliteal bypass is discussed. A series of patients that we have operated upon according to these criteria is analyzed. The low number of cases in our group of patients and the high rate of postoperative failures reflect our policy on this matter. PMID: 7085744, UI: 82214179 -------------------------------------------------------------------------------- 72: J Cardiovasc Surg (Torino) 1973 Jan-Feb;14(1):40-6 Related Articles, Books, LinkOut Roentgenographic diagnosis of Buerger's disease. Rivera R PMID: 4690976, UI: 73135784 -------------------------------------------------------------------------------- 73: Arch Surg 1986 Feb;121(2):217-20 Related Articles, Books, LinkOut Successful vein bypass in patients with an ischemic limb and a palpable popliteal pulse. Cantelmo NL, Snow JR, Menzoian JO, LoGerfo FW Patients presenting with an ischemic foot who have a palpable popliteal pulse have not always been considered to be suitable candidates for arterial reconstruction. Since 1976, 32 distal bypasses were performed in 30 such patients, 77% of whom were diabetic. Proximal anastomoses were from the distal superficial femoral or popliteal artery. Autologous vein was used in all cases. There were six graft failures, all of which occurred within eight months. Three failures, which all occurred within the first month, required below-the-knee amputation. Using life-table analysis, the one- and three-year patency rates were both 79%. One- and three-year limb-salvage rates were 89% and 82%, respectively. We conclude that the results of distal vein graft reconstruction originating from the superficial femoral or popliteal artery are comparable with those of any group of patients with arterial occlusive disease of a lower extremity. PMID: 3947218, UI: 86129849 -------------------------------------------------------------------------------- 74: Int J Dermatol 1989 Dec;28(10):672-3 Related Articles, Books, LinkOut Buerger's disease. Giblin WJ, James WD, Benson PM Department of Medicine, Walter Reed Army Medical Center, Washington, D.C. PMID: 2592131, UI: 90077715 -------------------------------------------------------------------------------- 75: Int Angiol 1991 Jul-Sep;10(3):178-81 Related Articles, Books, LinkOut Intraarterial perfusion of prostaglandin E1 after lumbar sympathectomy or reconstruction on femoropopliteal segment. Davidovic LB, Vranes MR, Lotina SI, Cernak IF, Velimirovic DB, Stojanov PL, Sindjelic RP, Sagic DZ, Cinara IS Institute for Cardiovascular Diseases, UCC, Belgrade, Yugoslavia. Out of 100 patients treated by intraarterial perfusion of prostaglandin E1 we selected 36 cases who have been treated after a lumbar sympathectomy or reconstruction on the femoro-popliteal segment. The patients were in the III and IV stage of occlusive diseases by Fontain. All patients were divided into four groups: (a) prostaglandin E1 after a lumbar sympathectomy (20); (b) prostaglandin E1 after failed femoro-popliteal bypass (8); (c) prostaglandin E1 with patent femoro-popliteal bypass and distal progression of the occlusive disease (3); (d) prostaglandin E1 with previously femoro-popliteal reconstruction and poor run off (5). After intraoperative introduction of a catheter into the superficial femoral artery, profunda femoral artery (a, b), a patent graft (c) or just implanted graft (d), a continuous intraarterial perfusion of prostaglandin E1 was applied, in doses 10 nanograms/kg body weight/minute, in total doses 3000 nanograms. The perfusion time was 48-72 h. The patients were controlled immediately after treatment as well as 1, 3, 6 and 12 months after. Our early and late results of the intraarterial perfusion of prostaglandin E1 proved as a very successful limb salvage procedure. PMID: 1765722, UI: 92113410 -------------------------------------------------------------------------------- 76: Angiology 1976 Sep;27(9):509-17 Related Articles, Books, LinkOut Onset and clinicopathological course in Buerger's disease. Nakata Y, Ban I, Hirai M, Shionoya S From clinicopathological study, vasculitis of Buerger's disease seemed to start at small branch arteries and veins and progress to the trunk artery with thrombus. Progress of vascular lesions in trunk artery was gradual in general; the pathogenesis was briefly discussed. PMID: 1053484, UI: 87023972 -------------------------------------------------------------------------------- 77: Aust N Z J Surg 1998 Jan;68(1):35-7 Related Articles, Books Impact of femoro-distal bypass on major lower limb amputation rate. Quigley FG, Ling J, Avramovic J Townsville General Hospital, Queensland, Australia. BACKGROUND: Limb salvage is one of the cardinal aims of vascular surgery, but the influence of distal bypasses on amputation rates has been difficult to demonstrate. METHODS: The incidence and indications for major limb amputations and infrapopliteal bypass during two consecutive 16-month periods were analysed. RESULTS: There was a decrease in the number of major amputations from 34 during the first period to 13 in the second, while the number of bypasses to the infrapopliteal arteries increased from four in the first period to 21 in the second. CONCLUSIONS: An increase in the incidence of bypasses to the infrapopliteal arteries was matched by a decrease in the number of major amputations. Factors that may have contributed to the increase in the incidence of distal bypass and the decrease in the number of amputations include the availability of digital subtraction angiography, and a change in referral patterns within the hospital so that, except for trauma, all patients who were considered to be candidates for major amputation were assessed by a vascular surgeon. PMID: 9440453, UI: 98101403 -------------------------------------------------------------------------------- 78: Ned Tijdschr Geneeskd 1996 Aug 31;140(35):1770-2 Related Articles, Books, LinkOut [Thromboangiitis obliterans (Buerger's disease) in 2 women]. [Article in Dutch] Njo KT, Smit AJ Ziekenhuis Bethesda, afd. Inwendige Geneeskunde, Hoogeveen. In two female patients with an ischaemic peripheral disease, 49 and 32 years old, thromboangiitis obliterans (Buerger's disease) was diagnosed. One suffered from ulceration of her left second toe, the other from pain of both hands followed by ulceration of two fingers. Both were smokers. Surgical treatment (amputation) was required, and they also had a prostacyclin infusion. They recovered and stopped smoking. Thromboangiitis obliterans is a non-arteriosclerotic, segmental occlusive disease of medium-sized and small arteries and veins, occurring predominantly in young male habitual smokers. In the nineteen-seventy less than 2% were women, but recent publications mention 23%, an increase which may be attributed to increased smoking in women. Recognition of Buerger's disease in women with peripheral occlusive arterial disease is important; the prognosis is good if they stop smoking. PMID: 8927130, UI: 96399796 -------------------------------------------------------------------------------- 79: Semin Vasc Surg 1993 Mar;6(1):14-23 Related Articles, Books, LinkOut Buerger's disease: a review and update. Mills JL, Porter JM Division of Vascular Surgery, University of South Florida College of Medicine, Tampa 33606. Publication Types: Review Review, tutorial PMID: 8252225, UI: 94073520 -------------------------------------------------------------------------------- 80: Minerva Cardioangiol 1993 Jul-Aug;41(7-8):331-4 Related Articles, Books, LinkOut [Buerger disease. Report of an case, unusual for its site and clinical manifestations]. [Article in Italian] Rispoli P, Castagno PL, Raso AM, Muncinelli M Insegnamento di Chirurgia Vascolare, Universita degli Studi di Torino. The diagnosis of Buerger's disease, like that of all arteritis, especially in the onset phase, can be difficult. The general criteria proposed by several authors, with the aim of codifying the verification of the disease, are sometimes too schematic and this collides with the existence of very variegated and polymorphous clinical situations, as well as totally atypical and unusual clinical patterns. On this subject we consider useful to report a case of Buerger's disease that presented some peculiar characteristics, the most important of which was the existence of an aneurysm of the left superficial temporal artery. PMID: 8233016, UI: 94050696 -------------------------------------------------------------------------------- 81: J Cardiovasc Surg (Torino) 1973 Jan-Feb;14(1):5-8 Related Articles, Books, LinkOut Clinical course and therapy of Buerger's disease. Stojanovic VK, Marcovic A, Arsov V, Bujanic J, Lotina S PMID: 4690979, UI: 73135787 -------------------------------------------------------------------------------- 82: Angiology 1985 Mar;36(3):191-6 Related Articles, Books, LinkOut Buerger's disease in women. A case report with critical approach to the literature. Cavallaro A, Meloni F, Sciacca V, Transi MG, DiGiacomo V The Authors describe a case of arteritis of the lower limbs in a woman, in which the clinico-angiographical features were suggestive for Buerger's disease, and this was confirmed by histological examination of the left posterior tibial artery. A bilateral lumbar sympathectomy was effective at least in slowing the course of the disease. PMID: 4025930, UI: 85277387 -------------------------------------------------------------------------------- 83: J Mal Vasc 1986;11(3):256-62 Related Articles, Books, LinkOut [The problem of Buerger-like arteriographic aspects observed in patients over 35 years of age with arterial disease]. [Article in French] Langeron P, Vasseur P Arteriographic appearances suggestive of Buerger's disease may be seen in patients considerably beyond the usual age of onset of the disease. Eliminating cases possibly resulting from an embolic process and diabetics, 9 patients were evaluated in the present study. Combined review of arteriographic, clinical, capillaroscopic and histological data led to the identification of 3 patient groups: Buerger's disease with ageing: 3 cases, intermediate or transitional forms: 4 cases, Finally, certain cases of arterial disease related to cold damage should be viewed in the context of the preceding forms: 2 cases. PMID: 3772257, UI: 87035371 -------------------------------------------------------------------------------- 84: Med Arh 1986;40(3):109-14 Related Articles, Books, LinkOut [Lumbar sympathectomy in the treatment of peripheral arterial diseases in the lower extremities]. [Article in Serbo-Croatian (Roman)] Solakovic E PMID: 3272312, UI: 90173449 -------------------------------------------------------------------------------- 85: Am J Surg 1991 Jun;161(6):672-6 Related Articles, Books A nine-year experience with crossover femoro-femoro-popliteal sequential bypass. Ellenby MI, Sawchuk AP, Schwarcz TH, Meyer JP, Montalvo J, Flanigan DP, Schuler JJ Department of Surgery, University of Illinois College of Medicine, Chicago. Multisegmental arterial occlusive disease may require a combined inflow and outflow procedure for optimal treatment of limb ischemia. Twenty-one patients with unilateral iliac artery stenosis or occlusion and ipsilateral superficial femoral artery occlusion underwent crossover femoro-femoro-popliteal sequential bypass during a 9-year period. Seventeen operations were for limb salvage. Patency rates were determined separately for each segment of the bypass. Primary patency rates for the femoro-femoral segment were 89%, 83%, and 57% at 1, 2, and 5 years, respectively. Primary patency rates for the femoro-popliteal segments were 68%, 62%, and 40% at 1, 2, and 5 years, respectively. Limb salvage rates were 100%, 90%, and 77% at 1, 2, and 5 years, respectively. This experience indicates that femoro-femoro-popliteal bypass is an effective treatment in selected patients with severe ischemia due to combined iliac artery and superficial femoral artery disease. PMID: 1862827, UI: 91320921 -------------------------------------------------------------------------------- 86: Surgery 1977 Dec;82(6):755-84 Related Articles, Books Autogenous venous grafts ten years later. DeWeese JA, Rob CG The status of 103 patients and their 113 autogenous venous femoropopliteal bypass grafts exactly 5 years after operation was presented previously. A 10 year follow-up now is possible. The mortality rate at 5 years was 48% (50 of 103) and at 10 years was 73% (75 of 103). Myocardial infarction was considered to be the cause of death of 36% of the 103 patients. The actual graft patency rate for survivors at 5 years was 59% (35 of 59) and at 10 years was 38% (11 of 29). Utilizing the same date, late graft patency rates of 45%, 58%, and 58% would have been calculated or predicted by other methods of reporting. Of 46 extremities operated on for claudication, 22 patients were alive and 45% of grafts (10 of 22) were patent 10 years later. Of patients with a total of 67 extremities operated on for rest pain or gangrene, only seven patients were alive and 14% (one of seven) of the grafts patent. Patency rates at 10 years of short grafts were 43% (nine of 21) and of long grafts 25% (two of eight). Extremities with good runoff had patency rates of 41% (nine of 22) at 10 years and those with poor runoff had patency rates of 29% (two of seven). Arteriograms demonstrated atherosclerotic changes in one of 18 grafts at 5 years and in two of eight grafts at 10 years. This study provides more facts for answering the questions of patients regarding long-term prognosis following their arterial reconstruction. It is important to analyze carefully any report in which a comparison of patency rates is suggested or invited. PMID: 929369, UI: 78055099 -------------------------------------------------------------------------------- 87: Scand J Thorac Cardiovasc Surg 1978;12(2):101-4 Related Articles, Books, LinkOut The immediate effect of lumbar sympathectomy on arterial blood flow measured by electromagnetic flowmetry. Vanttinen E, Inberg MV, Sotarauta M The immediate effect of lumbar sympathectomy on arterial blood flow was studied in 51 patients with peripheral arterial disease by means of electromagnetic flowmetry. Concomitant arterial reconstruction was performed in 37 cases. The measurement was made on the reconstructed segment or on the bypass graft, and on the femoral artery when sympathectomy alone was performed. The flow increase varied considerably from case to case and was rather unpredictable. There was no significant correlation between the effect of sympathectomy and peripheral arterial disease or the condition of the outflow tract. Thus, on the basis of these measurements, it is difficult to determine the significance of lumbar sympathectomy as a method of increasing blood flow. PMID: 715392, UI: 79055982 -------------------------------------------------------------------------------- 88: West J Med 1998 Apr;168(4):255-60 Related Articles, Books, LinkOut Thromboangiitis obliterans. An update on Buerger's disease. Szuba A, Cooke JP Department of Cardiovascular Medicine, Stanford University School of Medicine, California 94305, USA. Buerger's disease (thromboangiitis obliterans) is a nonnecrotizing vasculitis affecting small and medium-sized arteries, typically in young male smokers. The diagnosis can often be made on the basis of a careful history and physical examination, together with ancillary laboratory studies. Occasionally arteriography is warranted to confirm the diagnosis. The pathological findings are distinctive and distinguish this disorder from other arterial occlusive diseases. Successful therapy is possible only with absolute abstinence from tobacco. Publication Types: Review Review, tutorial Comments: Comment in: West J Med 1998 Apr;168(4):286-7 PMID: 9584663, UI: 98245642 -------------------------------------------------------------------------------- 89: Eur J Vasc Endovasc Surg 1997 Nov;14(5):417-8 Related Articles, Books Graft failure and amputation. Dardik H Publication Types: Comment Letter Comments: Comment on: Eur J Vasc Endovasc Surg 1997 May;13(5):477-85 PMID: 9413391, UI: 98075312 -------------------------------------------------------------------------------- 90: Surgery 1980 Sep;88(3):357-65 Related Articles, Books, LinkOut Sequential femoral-tibial bypass for severe limb ischemia. Flinn WR, Flanigan DP, Verta MJ Jr, Bergan JJ, Yao JS Jr Sequential femoral-popliteal-tibial bypass has been recommended for surgical treatment of severe lower limb ischemia in patients with complex multisegmental arterial occlusion. To evaluate this alternative technique critically, sequential grafting was performed in 40 limbs with severe ischemia manifest by rest pain (20), nonhealing ulceration (eight), or gangrene (12). Measurement of segmental Doppler arterial pressure revealed a significant increase in ankle brachial index from 0.29 0.15 before operation to 0.93 0.12 after operation, confirming the hemodynamic improvement among these patients. In the early postoperative period occlusion of the distal graft segment was recognized in 12 patients by a characteristic reduction of the ankle/brachial index (0.50 0.14), while the low thigh pressures remained unchanged. Recurrent severe ischemia was prevented in most by persistent patency of the proximal graft segment. Overall, significant hemodynamic improvement was achieved in 29 of 38 limbs, a limb salvage rate (76%) comparable to that reported for femoral-distal bypass or femoral-popliteal bypass to an isolated popliteal segment. Early graft failure in this series resulted in major amputation in eight of 16 limbs, a significantly lower rate than for these other techniques. Sequential bypass grafting is a useful alternative method for limb salvage. The preservation of the proximal graft patency after distal segmental occlusion may be an important characteristic of this type of reconstruction. PMID: 7414513, UI: 81015842 -------------------------------------------------------------------------------- 91: Surgery 1981 Dec;90(6):980-90 Related Articles, Books, LinkOut Superficial femoral and popliteal arteries as inflow sites for distal bypasses. Veith FJ, Gupta SK, Samson RH, Flores SW, Janko G, Scher LA In a series of limb salvage bypass to the popliteal and infrapopliteal arteries, the superficial femoral and popliteal arteries were used preferentially to provide inflow if these vessels were no more than minimally diseased proximal to the site of bypass origin. Cumulative life-table patency rate at 6 years for popliteal bypasses was 66% for 290 cases originating from the common femoral and 81% for 60 cases originating from the superficial femoral and popliteal arteries (P greater than 0.1). Infrapopliteal bypass patency rate at 5 years was 50% for 129 cases originating from the common femoral artery and 58% for 79 cases originating more distally (P greater than 0.25). When vein grafts alone were considered, patency rates were still not influenced by the site of origin of popliteal and infrapopliteal bypasses. Only 1 of 32 failures of a bypass with a distal origin could have been caused by proximal progression of disease. Because of these findings and multiple advantages that result from using arteries distal to the common femoral for bypass inflow, preferential use of the superficial femoral and popliteal arteries for this purpose is recommended in appropriately selected patients. PMID: 7313952, UI: 82085112 -------------------------------------------------------------------------------- 92: Jpn J Surg 1980 Sep;10(3):245-50 Related Articles, Books, LinkOut Long-term results of reconstructive surgery for femoro-popliteal arterial occlusive lesions. Kusaba A, Inokuchi K, Mutoh Y, Moriyama M, Furuyama M, Kamori M, Kina M A retrospective review of 156 reconstructions performed for femoro-popliteal arterial occlusive lesions in 141 patients was carried out in terms of the reconstructive procedure and the degree of out-flow in the distal vessel. The cumulative patency rate for 95 autogenous vein grafts was 60.7 per cent at 12 years and higher than the 27.4% patency rate for 50 endarterectomies (p less than 0.001). All of 11 synthetic bypass prostheses failed with late thrombosis within 3 years after operation. The cumulative patency rate in cases with good distal run-off vessel and those with fair distal run-off vessel were 77.1% at 11 years and 57.3% at 12 years, respectively, and these values were significantly superior to 10.3% in cases with poor distal run-off vessel. The patency rate for 41 in situ grafts was 72.2%, being superior to 65.5% for 42 free grafts. PMID: 7218602, UI: 81171070 -------------------------------------------------------------------------------- 93: J Cardiovasc Surg (Torino) 1982 Sep-Oct;23(5):411-4 Related Articles, Books Criteria for prognostic evaluation of the results of lumbar sympathectomy: clinical, haemodynamic and angiographic findings. Pistolese GR, Speziale F, Taurino M, Spartera C, Faraglia V Lumbar sympathectomy still has an important role in the surgical treatment of occlusive peripheral arterial diseases of the lower limbs located below the inguinal ligament, when the presence of peripheral lesions makes revascularization difficult. A consecutive series of 143 patients who underwent lumbar sympathectomy was considered, and the clinical, angiographic and haemodynamic findings evaluated. Haemodynamic studies on these patients showed a relation between the clinical improvement and the pressure index, measured at the ankle before lumbar sympathectomy. The patients with pressure index values above 0.5 had a symptomatic improvement whereas the patients with a pressure index below 0.3 gave less good results. It is therefore believed that lumbar sympathectomy showed not be considered a second operative choice but an elective operation, especially in patients affected by lesion of the superficial femoral artery, the popliteal artery and its branches, with pressure indices above 0.5 where revascularization is not possible. PMID: 7130263, UI: 83030950 -------------------------------------------------------------------------------- 94: Practitioner 1973 Dec;211(266):823-4 Related Articles, Books, LinkOut Buerger's disease. Leo Buerger (1879-1943). Birch CA Publication Types: Historical article Biography Personal Name as Subject: Buerger L PMID: 4595799, UI: 74144921 -------------------------------------------------------------------------------- 95: Surg Gynecol Obstet 1985 Aug;161(2):129-32 Related Articles, Books, LinkOut Prognostic indicators in femoropopliteal and distal bypass grafts. Barry R, Satiani B, Mohan B, Smead WL, Vaccaro PS Over a period of six years, 265 femoropopliteal and infrapopliteal bypasses were performed in 243 patients with infrainguinal arterial occlusive disease. The cumulative patency rate for all grafts was 70.9 per cent at one year, 59.3 per cent at three years and 48.5 per cent at five years. Femoropopliteal bypasses showed a significantly better patency rate than femoral infrapopliteal grafts and autogenous vein grafts had a significantly higher patency rate than human umbilical vein grafts. No demonstrable difference in patency rates was shown in patients with and without diabetes. Synchronous proximal and distal revascularization for limb salvage in properly selected patients with multisegmental disease achieved a cumulative patency rate of 100 per cent at two years with no operative deaths. Therefore, this procedure is recommended, but individualization of treatment rather than routine synchronous repair is urged. PMID: 4023893, UI: 85272997 -------------------------------------------------------------------------------- 96: Ann Vasc Surg 1987 Dec;1(5):591-4 Related Articles, Books, LinkOut Aortitis presenting as Buerger's disease. White RA, Peng SK, Klein SR, White G, Uitto J Department of Surgery, Harbor-UCLA Medical Center, Torrance 90509. Buerger's disease is frequently diagnosed in young smokers, based on clinical presentation rather than histologic criteria. This report describes a young male with idiopathic aortitis who had been managed for 10 years as Buerger's disease solely on the basis of clinical manifestations. This case emphasizes the need for establishing histopathologic, and perhaps biochemical, criteria to identify the underlying arteriopathy. PMID: 3504700, UI: 89076798 -------------------------------------------------------------------------------- 97: Nippon Geka Gakkai Zasshi 1990 Mar;91(3):419-23 Related Articles, Books [Late results with biograft in peripheral arterial surgery]. [Article in Japanese] Matsui Y, Goh K, Sakuma M, Yasuda K, Tanabe T 2nd Department of Surgery, Hokkaido University of Medicine, Sapporo, Japan. A total of 106 vascular reconstructions below the inguinal ligament including axillo-femoral and femoro-femoral bypasses were performed using 137 Dardik's human umbilical veins. The indication for surgery was limb salvage in 29%. The distal anastomosis was done with the popliteal artery above the knee in 53 cases, below the knee in 31, and with a tibial artery in 1. The axillo-femoral bypass was performed in 21 cases, and femoro-femoral bypass in 32. The accumulated graft patency rates of femoro-popliteal bypass at 1 yr./3 yrs./5 yrs. were 93%/75%/75%, those of femoro-femoral bypass were 85%/85%/85%, and those of axillo-femoral bypass were 54%/27%/27%. No special risk factor influencing patency rate was found from this study. In long term period, graft aneurysm was observed in 3 cases. It is concluded that the human umbilical vein is the graft material of choice for femoro-popliteal or femoro-femoral bypass when the saphenous vein is not available, and the careful follow-up is important because of the risk of graft aneurysm. PMID: 2359399, UI: 90294792 -------------------------------------------------------------------------------- 98: Am J Surg 1991 Jul;162(1):19-23 Related Articles, Books, LinkOut Bypass grafting to the popliteal artery in limbs with occluded crural arteries. Karacagil S, Almgren B, Bowald S, Eriksson I Department of Surgery, University Hospital, Uppsala, Sweden. Intraoperative completion angiograms of 47 femoropopliteal bypasses in limbs with occluded crural arteries were reviewed to identify the angiographic determinants of early outcome. Of 28 limbs in which the foot vessels were available for analysis, only 2 (7%) had an intact pedal circulation, and 18 limbs demonstrated no crural arteries suitable for distal reconstruction. The overall cumulative patency rate was 51% with a 76% limb salvage rate at 12 months. All seven grafts performed onto a popliteal artery segment of less than 8 cm occluded in the early period. The status of crural and foot arteries and the number of collaterals did not correlate well with early patency. Limbs with no patent crural artery that were analyzed in the poor angiographic runoff group, according to our previously reported classification, demonstrated relatively higher patency rates than the other subgroups with poor runoff. In cases where angiography demonstrates a poor runoff for distal revascularization, popliteal bypass with occluded crural arteries might achieve acceptable patency rates. PMID: 2063964, UI: 91290170 -------------------------------------------------------------------------------- 99: Acta Chir Iugosl 1978;25 Suppl 1(1 Suppl):225-9 Related Articles, Books [Surgical reconstructive treatment of blood vessels in the popliteal region]. [Article in Serbo-Croatian (Roman)] Kruzic Z, Luetic V, Tonkovic I, Custovic F, Simunic I Severe occlusive disease frequently includes the popliteal artery and origin of the trifurcation vessels with reconstruction of one or more of the crural arteries. We made femorocrural bypass 23 times. Our indications for operation continue to be relief of pain or salvage of extremity. Of the 23 grafts during of one year period block recurred in 8 patients. Five times we made amputation and good results we had in 15 patients. In one patient we used Gore-tex prosthesis with succses in 4 month period. PMID: 654769, UI: 78183494 -------------------------------------------------------------------------------- 100: Thoraxchir Vask Chir 1977 Apr;25(2):83-7 Related Articles, Books, LinkOut [Vascular reconstruction in arterial occlusion of the lower leg]. [Article in German] Gall F, Franke F, Husfeldt J In 84% of 115 femoro-crural arterial occlusions stage III and IV was present. All operations to revascularisation, including second operations could be performed without lethality. On leaving hospital in 93% the bypass was patent. Two to nine years after the operation in 64% of the venous grafts were good. Only eleven patients have had to subject amputations because of bypass occlusion since reconstruction. Our results prove that the femoro-crural reconstruction in arterial occlusion of the lower leg is superior to lumbar sympathectomy and the conservative treatment. PMID: 300915, UI: 77175394 -------------------------------------------------------------------------------- 101: J Korean Med Sci 2000 Feb;15(1):44-8 Related Articles, Books, LinkOut Morphologic change of the internal elastic lamina in Buerger's disease. Kim EJ, Cho BS, Lee TS, Kim SJ, Seo JW Department of Pathology, Seoul National University, College of Medicine, Korea. Morphologic features and pathogenesis of arterial changes occurring in Buerger's disease (thromboangiitis obliterans) are still controversial. This study describes histopathologic features of medium sized arteries from patients with Buerger's disease, particularly of the internal elastic lamina in relation to the immunologic mechanism of the injury. Seventeen segments of occluded arteries (femoral or popliteal arteries) from 17 patients with Buerger's disease were analyzed by histopathological and immunohistochemical methods. The most characteristic features were total luminal obliteration, together with a varying degree of recanalization and deposition of hemosiderin pigments. Detailed analysis, however, showed marked undulation and multiplication of the internal elastic lamina (100%) associated with basophilic degeneration and delicate linear calcification (47%). Lymphocytic infiltration along the internal elastic lamina was seen in 71% and was associated with localized edema. Lymphocytes along the lamina were consistently positive for T cell marker. Mild to moderate fibrosis was present at the media in 24%. Adventitial changes included mild, nonspecific and irregular fibrosis seen in 53%. Immunologic injury to the internal elastic lamina associated with T-lymphocytic infiltration might be the initial morphogenetic mechanism of the thrombotic occlusion and organization of medium-sized arteries in Buerger's disease. PMID: 10719807, UI: 20182726 -------------------------------------------------------------------------------- Summary Brief Abstract Citation MEDLINE ASN.1 LinkOut Related Articles Protein Links Nucleotide Links Popset Links Structure Links Genome Links Show: 5 10 20 50 100 200 500 Items 1-101 of 101 One page. Write to the Help Desk NCBI | NLM | NIH Department of Health & Human Services Freedom of Information Act | Disclaimer
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Keywords: ISCHEMIC LIMBS, REST PAIN, NEOVASCULARISATION, PERIOSTEUM, CORTICOTOMY
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