Buerger's disease diagnostic study of choice
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hadeel Maksoud M.D.[2]
Overview
Although clinical examination is sufficient for diagnosis, in cases where diagnosis is not definitive, a catheter-based arteriogram is the gold standard test for the diagnosis of Buerger disease. The following result of catheter-based arteriogram is confirmatory of Buerger disease and includes, absence of atherosclerosis, no cause for thromboembolism, small and medium-sized vessels involved, namely tibial, popliteal, and radial arteries, segmental affection of vessels between normal appearing segments and corkscrew collaterals described as collateralization around occlusion area but are not pathognomonic.
Diagnostic Study of Choice
Study of choice
- Although clinical examination is sufficient for diagnosis, in cases where diagnosis is not definitive, a catheter-based arteriogram is the gold standard test for the diagnosis of Buerger disease.
- The following result of catheter-based arteriogram is confirmatory of Buerger disease:
- Absence of atherosclerosis
- No cause for thromboembolism
- Small and medium-sized vessels involved, namely tibial, popliteal, and radial arteries
- Segmental affection of vessels between normal appearing segments
- Corkscrew collaterals described as collateralization around occlusion area but are not pathognomonic
Sequence of Diagnostic Studies
- The catheter-based arteriogram should be performed when:
- The patient presents with symptoms and signs that are consistent with Buerger's disease but not definite.
Diagnostic Criteria
- The diagnosis of Buerger's disease is based on the Shionoya's criteria, which includes:
- Less than 45 years old
- Past or current history of tobacco intake
- Ischemia of the distal extremities
- Arteriographic findings suggestive of thromboangiitis obliterans
- Exclusion of another organic causes such as a source of embolism, autoimmune disease, thrombophilia, or diabetes mellitus