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Case Reports
. 2016 Feb;13(1):97-100.
doi: 10.1111/iwj.12241. Epub 2014 Feb 25.

Extreme distal bypass to improve wound healing in Buerger's disease

Giovanni De Caridi  1 , Mafalda Massara  1 , Simona Villari  1 , Eugenio Martelli  1 , Francesco Spinelli  1 , Raffaele Grande  2 , Lucia Butrico  2 , Stefano de Franciscis  2   3 , Raffaele Serra  2   3
Affiliations
Case Reports

Extreme distal bypass to improve wound healing in Buerger's disease

Giovanni De Caridi et al. Int Wound J. 2016 Feb.

Abstract

Thromboangiitis obliterans or Buerger's disease is a rare non-atherosclerotic segmental inflammatory vasculitis that most commonly involves small and medium-sized arteries, veins and nerves of the extremities, and generally affects young tobacco smokers. A 53-year-old man was found to have critical ischaemia of his left lower limb with foot gangrene. He underwent extremely distal surgical revascularisation using a great saphenous vein bypass graft. The choice of a very distal artery as run-off vessel promoted a faster wound healing and pain relief, with improvement in quality of life.

Keywords: Surgery; Thromboangiitis obliterans; Wound healing.

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Figures

Figure 1
Figure 1
Gangrene and tissue loss at the site of the first finger after transmetatarsal amputation of the left foot.
Figure 2
Figure 2
Arteriography revealed normal proximal vessels but distal small‐ and medium vessels disease. An important collateral circulation was observed at the level of thigh (A) and leg (B). Only a segment of plantar artery resulted patent (C).
Figure 3
Figure 3
Intraoperative angiographic (A) and surgical (B) image of the distal anasthomosis.
Figure 4
Figure 4
Complete wound healing of the foot after surgical revascularisation of the left lower limb.
See this image and copyright information in PMC

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