Clinical outcome after extended endovascular recanalization in Buerger's disease in 20 consecutive cases

Lanfroi Graziani, Luis Morelli, Francesca Parini, Laura Franceschini, Pierfranco Spano, Stefano Calza, Sandra Sigala

Research output: Contribution to journalArticle

Abstract

Background: To present our experience of extended endovascular management for thromboangiitis obliterans (Buerger's disease) patients with critical limb ischemia (CLI). Methods: Between January 2005 and July 2010, a consecutive series of 17 Buerger's disease patients with CLI in 20 limbs were admitted and the diagnosis confirmed. The mean age of the patients was 41.5 years (standard error: ±1.7). All patients presented with history of smoking, one patient presented with hypertension, and eight patients presented with dyslipidemia. According to Rutherford classification, all patients were found to be between grades 3 and 5. Ultrasonography first, and angiography examination later, confirmed a severe arterial disease involving almost exclusively below-the-knee and foot arteries in all cases. A new approach for revascularization, defined as extended angioplasty of each tibial and foot artery obstruction, was performed to achieve direct perfusion of at least one foot artery. Results: An extensive endovascular treatment was intended in all patients with success in 19 of 20 limbs, achieving a technical success in 95%. No mortality or complication related to the procedure was observed. During a mean follow-up of 23 months (standard error: ±4.05), amputation-free survival with no need of major amputation in any case and sustained clinical improvement was achieved in 16 of the 19 limbs (84.2%) successfully treated, resulting in a 100% limb salvage rate (19/19). Conclusion: In this first experience, in patients with thromboangiitis obliterans, extended endovascular intervention was a feasible and effective revascularization procedure in case of CLI. High technical success, amputation-free survival, and sustained clinical improvement rates were achieved at midterm follow-up was achieved.

Original languageEnglish
Pages (from-to)387-395
Number of pages9
JournalAnnals of Vascular Surgery
Volume26
Issue number3
DOIs
Publication statusPublished - Apr 2012

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Thromboangiitis Obliterans
Extremities
Amputation
Ischemia
Foot
Arteries
Tibial Arteries
Limb Salvage
Survival
Dyslipidemias
Angioplasty
Ultrasonography
Knee
Angiography
Perfusion
Smoking
Hypertension

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Graziani, L., Morelli, L., Parini, F., Franceschini, L., Spano, P., Calza, S., & Sigala, S. (2012). Clinical outcome after extended endovascular recanalization in Buerger's disease in 20 consecutive cases. Annals of Vascular Surgery, 26(3), 387-395. https://doi.org/10.1016/j.avsg.2011.08.014

Clinical outcome after extended endovascular recanalization in Buerger's disease in 20 consecutive cases. / Graziani, Lanfroi; Morelli, Luis; Parini, Francesca; Franceschini, Laura; Spano, Pierfranco; Calza, Stefano; Sigala, Sandra.

In: Annals of Vascular Surgery, Vol. 26, No. 3, 04.2012, p. 387-395.

Research output: Contribution to journalArticle

Graziani, L, Morelli, L, Parini, F, Franceschini, L, Spano, P, Calza, S & Sigala, S 2012, 'Clinical outcome after extended endovascular recanalization in Buerger's disease in 20 consecutive cases', Annals of Vascular Surgery, vol. 26, no. 3, pp. 387-395. https://doi.org/10.1016/j.avsg.2011.08.014
Graziani, Lanfroi ; Morelli, Luis ; Parini, Francesca ; Franceschini, Laura ; Spano, Pierfranco ; Calza, Stefano ; Sigala, Sandra. / Clinical outcome after extended endovascular recanalization in Buerger's disease in 20 consecutive cases. In: Annals of Vascular Surgery. 2012 ; Vol. 26, No. 3. pp. 387-395.
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