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Endovascular Recanalization of Thromboangiitis Obliterans (Buerger’s Disease) in Twenty-Eight Consecutive Patients and Combined Antegrade–Retrograde Intervention in Eight Patients

Authors
  • Firat, Ali1
  • Igus, Behlul1
  • 1 Baskent University Istanbul Hospital, Department of Radiology, Istanbul, 34662, Turkey , Istanbul (Turkey)
Type
Published Article
Journal
CardioVascular and Interventional Radiology
Publisher
Springer-Verlag
Publication Date
Mar 04, 2019
Volume
42
Issue
6
Pages
820–828
Identifiers
DOI: 10.1007/s00270-019-02193-x
Source
Springer Nature
Keywords
License
Yellow

Abstract

PurposeThe aim of the study was to evaluate the technical success of the procedure and the clinical efficacy of treatment in patients with thromboangiitis obliterans (TAO) (Buerger’s disease) based on a change in the Rutherford classification.Materials and MethodsA total of 28 consecutive patients (26 males, 2 females, mean age 43.3 ± 5.32 years) underwent endovascular recanalization with a diagnosis of TAO, between April 2015 and July 2018. After unsuccessful attempts using the antegrade approach, retrograde approaches were used in 8 patients under ultrasound guidance. Clinical follow-up was routinely performed at 1-month, 3-month, 6-month, and 1-year intervals.ResultsA total of 28 TAO patients underwent 40 procedures in 32 limbs. Technical success was achieved in 28 of the 32 limbs (87.5%). In total, 45 of 59 (76.2%) below the knee arteries were treated successfully. One major amputation was performed, providing a 96.8% rate for limb salvage both at 12 and 24 months. Amputation-free survival estimated by Kaplan–Meier analysis was 84% at 12 and 24 months. Primary patency rates at 12, 24, and 36 months were 84%, 78%, and 75%, respectively. Secondary patency rates were 87.5% both at 12 and 24 months.ConclusionEndovascular treatment is a technically feasible and potentially effective treatment modality for Buerger’s disease. Combined antegrade and retrograde interventions in TAO patients may improve technical success and clinical recovery, especially in cases where the antegrade approach has failed.

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