Endovascular management of Buerger disease

Abstract

Thromboangiitis obliterans (TAO), widely known as Buerger’s disease, is a non-atherosclerotic segmental disease, characterized by occlusive, inflammatory, and thrombotic changes, and highly cellular with polymorph nuclear leukocytes, microabscesses, and multinucleated giant cell, affecting most commonly small- and medium-sized arteries and superficial veins of legs and arms. Tobacco use, in any of its forms, plays a central role in the pathogenesis and progression of the condition. High-risk amputation rates are still reported even with conservative therapies such as smoke cessation wound, and pain management, describing a total amputation rate of 33 % in most recent series. Surgical revascularization is usually not possible for patients with Buerger’s disease, because of the diffuse distal involvement, with no distal run-off vessels available for bypass surgery. Only recently the first experience on the endovascular treatment of TAO has been published, reporting very promising results.