Fate of limbs with failed vascular reconstruction in Buerger's disease patients

We surveyed the recent condition of lower limbs with failed vascular recons truction in patients with Buerger's disease. Forty-three patients (mean age : 41.2+/-8.7 years) received infrapopliteal vascular reconstruction at Nago ya University Hospital. Symptoms at the time of surgery were intermittent c laudication in 11 patients, rest pain in 13 and ulcer/gangrene in 19. Inqui ry about the condition of the lower limbs was made during March 1998. Eight patients were lost to follow-up and three patients had died. In the remain ing 32 patients, mean follow-up period was 140.5+/-42.0 months. Graft was o ccluded within a week after surgery in six patients with ischemic ulcer/gan grene, three of whom underwent a major amputation while the trophic lesion healed in the remaining three patients. Two grafts were occluded among the 11 patients with intermittent claudication. One of these patients had mild rest pain and the other reported intermittent claudication. Two of the pati ents with intermittent claudication were lost to follow-up. Among the 13 pa tients with rest pain, one had died and six were lost-to-follow-up. Althoug h the remaining six patients complained of intermittent claudication, half had an occluded graft. Of the 19 patients with ulcer/gangrene, two had died and all nine of those with occluded graft complained of intermittent claud ication. Fate of limbs with failed vascular reconstruction was satisfactory . (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.