Percutaneous Retrograde Access for Recanalization of Occluded Arteries in Thromboangiitis Obliterans (Buerger’s Disease)

Background: Thromboangiitis obliterans (TAO) or Buerger’s disease is a non-atherosclerotic peripheral vascular disease, which affects mainly young male smokers before the age of 45, especially in low socioeconomic regions. The aim of the study was to evaluate the technical success of the percutaneous retrograde access procedure after failed antegrad recanalization in Thromboangiitis Obliterans (Buerger’s Disease) patients. Method(s): Thirteen consecutive patients (12 men, 1 women, mean age: 40.3 ± 5.6 years) and 14 arteries underwent retrograde puncture for recanalization with a diagnosis of TAO (Thromboangiitis Obliterans), between April 2015 and December 2018. After unsuccessful attempts using the antegrade approach, retrograde puncture were used under ultrasound and fluoroscopic guidance. Ipsilateral retrograde access was attempted in three patients with SFA (superficial femoral artery) in three patients with PTA (posterior tibial artery), in two patients with PEA (peroneal artery) and in five patients ATA (anterior tibial artery). The primary purpose of the study was to evaluate the technical success of the procedure in obtaining the ability to pass the wire across target artery and providing blood flow to the below the knee arteries. Result(s): Technical success was achieved 12 of 13 arteries (92.3%). In a patient who underwent PTA puncture, the retrograde approach failed because the guidewire could not be passed through the occlusive artery. There were no major complications in any of the cases. Conclusion(s): Endovascular treatment is a technically feasible and potentially effective treatment modality for Buerger’s disease. Retrograde interventions in TAO patients may improve technical success and clinical improvement, especially in cases where antegrade approach fails.

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Artikel online veröffentlicht:
11. Mai 2021