Corkscrew Collaterals in Thromboangitis Obliterans (Buerger’s Disease)

Abstract

HomeCirculationVol. 116, No. 21Corkscrew Collaterals in Thromboangitis Obliterans (Buerger’s Disease) Free AccessReview ArticlePDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissionsDownload Articles + Supplements ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toSupplementary MaterialsFree AccessReview ArticlePDF/EPUBCorkscrew Collaterals in Thromboangitis Obliterans (Buerger’s Disease) Yuichi Fujii, MD, Kenji Nishioka, MD, PhD, Masao Yoshizumi, MD, PhD, Kazuaki Chayama, MD, PhD and Yukihito Higashi, MD, PhD Yuichi FujiiYuichi Fujii From the Departments of Medicine and Molecular Science (Y.F., K.N., K.C.) and Cardiovascular Physiology and Medicine (M.Y., Y.H.), Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan. Search for more papers by this author , Kenji NishiokaKenji Nishioka From the Departments of Medicine and Molecular Science (Y.F., K.N., K.C.) and Cardiovascular Physiology and Medicine (M.Y., Y.H.), Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan. Search for more papers by this author , Masao YoshizumiMasao Yoshizumi From the Departments of Medicine and Molecular Science (Y.F., K.N., K.C.) and Cardiovascular Physiology and Medicine (M.Y., Y.H.), Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan. Search for more papers by this author , Kazuaki ChayamaKazuaki Chayama From the Departments of Medicine and Molecular Science (Y.F., K.N., K.C.) and Cardiovascular Physiology and Medicine (M.Y., Y.H.), Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan. Search for more papers by this author and Yukihito HigashiYukihito Higashi From the Departments of Medicine and Molecular Science (Y.F., K.N., K.C.) and Cardiovascular Physiology and Medicine (M.Y., Y.H.), Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan. Search for more papers by this author Originally published20 Nov 2007https://doi.org/10.1161/CIRCULATIONAHA.107.728717Circulation. 2007;116:e539–e540A 47-year-old man with a 15-year history of Buerger’s disease presented with sharp rest pain and ischemic necrosis at the tips of the toes of his right foot. Early treatments, including treatment with antithrombotic and vasodilating agents and sympathetectomy, did not improve his symptoms or ulcer. Minor amputation of the toes of his right foot was performed. Digital subtraction angiography showed avascular areas at the tip of the index finger and multiple occlusions of the distal arteries, with collateralization (corkscrew collaterals) around the area of occlusions in the right lower leg. Continuous-wave Doppler ultrasound is useful to assess lower-extremity peripheral arterial disease anatomy, severity, and progression. Corkscrew collaterals (Figure, A [arrows B and C]) in the right leg were able to be visualized as color Doppler flows of a snake sign (Figure, A [arrow B] and B, and online-only Data Supplement Movie) and a dot sign (Figure, A [arrow C] and C) through the use of continuous-wave Doppler ultrasound. Download figureDownload PowerPointFigure. A, Digital subtraction angiography shows corkscrew collaterals around the area of occlusions in the right lower leg. Continuous-wave Doppler ultrasound shows corkscrew collaterals as color Doppler flows of a snake sign (A [arrow B] and B) and a dot sign (A [arrow C] and C).The online-only Data Supplement, which contains a movie, can be found at http://circ.ahajournals.org/cgi/content/full/116/21/e539/DC1.DisclosuresNone.FootnotesCorrespondence to Yukihito Higashi, MD, PhD, FAHA, Department of Cardiovascular Physiology and Medicine, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan. E-mail [email protected] Previous Back to top Next FiguresReferencesRelatedDetailsCited By Kawarada O, Kume T, Ayabe S, Nakaya T, Nakai M, Nishimura K, Noguchi T, Yokoi Y, Ogawa H and Yasuda S (2017) Endovascular Therapy Outcomes and Intravascular Ultrasound Findings in Thromboangiitis Obliterans (Buerger’s Disease), Journal of Endovascular Therapy, 10.1177/1526602817710917, 24:4, (504-515), Online publication date: 1-Aug-2017. Akar A, İnan M and Baran Ç (2016) Thromboangiitis Obliterans, Current Treatment Options in Rheumatology, 10.1007/s40674-016-0047-6, 2:2, (178-195), Online publication date: 1-Jun-2016. Abyshov N, Abdullayev A, Zakirdzhaev E, Guliyev R, Akhmedov M, Tagizade G, Zeynalova G and Mamedova L (2016) The results of combined surgical treatment of thromboangiitis obliterans and critical lower limb ischemia using prolonged epidural analgesia and autohemotherapy with ozone, Khirurgiya. Zhurnal im. N.I. Pirogova, 10.17116/hirurgia2016945-50:9, (45), . Hackl G, Milosavljevic R, Belaj K, Gary T, Rief P, Hafner F, Lipp R and Brodmann M (2014) The value of FDG-PET in the diagnosis of thromboangiitis obliterans—a case series, Clinical Rheumatology, 10.1007/s10067-014-2648-5, 34:4, (739-744), Online publication date: 1-Apr-2015. 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November 20, 2007Vol 116, Issue 21 Advertisement Article InformationMetrics https://doi.org/10.1161/CIRCULATIONAHA.107.728717PMID: 18025397 Originally publishedNovember 20, 2007 PDF download Advertisement SubjectsDiagnostic Testing