Abstract No. 224: Are “Cork-Screw Collaterals” Really Pathognomic to Buerger’s Disease?

Abstract

It has been well known that the “cork-screw collateral” is pathognomic finding in Buerger’s disease (BD). Purpose of this study was to evaluate whether the cork-screw collateral is really pathognomonic to BD by comparing angiographic findings of BD and atherosclerosis obliterans (ASO) patients, and to evaluate angiographic differential points between the two groups. The authors retrospectively reviewed 51 angiograms in clinically diagnosed 34 BD patients group and 43 angiograms inclinically diagnosed, 31 ASO patients group who had significant arterial stenosis/occlusion for recent 3 years. We reviewed presence of the cork-screw collaterals of the two groups. When present, we classified them as four grades: mild, moderate, and severe degrees. The sites of occlusion or involvement and run-off of the two groups were also evaluated. Statistical analysis for incidence and degree of the collaterals were performed in the two groups. Cork-screw collaterals appeared in 45/51 (88.2%) of the BD group and 30/43 (69.8%) of the ASO group. Grades of cork –screw collaterals of BD group were mild in 13.3%, moderate in 35.6%, and severe in 51.1%. In ASO group, those were 63.3 %, 26.7%, and 10.0% respectively. Sites of steno-occlusion were single or localized in 98.0% of BD group, but multiple or systemic in 86.1% of ASO group. The run-off vessels were visible in 37.3% of BD group and 88.7% of ASO group. Cork-screw collateral is not pathognomic to BD, but it also presents in ASO patients. However, the incidence is higher and the degree of the collateral is severer in BD than in ASO. BD has a tendency of localized involvement but ASO involves systemically. And development of run-off vessels is poorer in BD than in ASO.