ANGIOGRAPHIC FINDINGS IN BUERGER-DISEASE

To clarify the angiographic findings in patients with Buerger disease and to elucidate the relationship between the angiographic findings an d the clinical prognosis, 144 angiographic images of the lower extremi ties of 119 patients with Buerger disease have been studied. The prese nt study has included patient data in our previous report. Results of this study revealed that in lower extremities showing a femoropoplitea l arterial occlusion (n = 57), the frequency of gangrene was significa ntly lower statistically in limbs in which the main arteries of the lo wer leg and foot were well visualized (2 (12%) of 17 limbs) than in li mbs in which the main arteries did not visualize (25 (63%) of 40 limbs ) (P < 0.001). Further, in lower extremities showing a crural arterial occlusion (n = 59), the incidence of pedal gangrene increased as the extent of pedal arterial occlusion increased, though this rise was not statistically significant. Also, the collateral vessels had a 'corksc rew' appearance in 39 (27%) of 144 limbs affected by Buerger disease, whereas this appearance was seen in only 2 (3%) of 63 limbs of patient s with arteriosclerosis obliterans (P < 0.001). Another finding of thi s study is that corkscrew-shaped vessels that extend from the sites of the arterial occlusion to the periphery of the feet without opacifica tion of the main pedal arteries indicate a poor prognosis. Based on th e above findings, we thus believe that the appearance of corkscrew-sha ped vessels is the most characteristic feature of Buerger disease and that each represents a dilated vasa vasorum of the occluded main arter ies.