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.
