Abstract 13324: Outcomes of Endovascular Therapy and Intravascular Ultrasound Findings for Thromboangiitis Obliterans (Buerger’s Disease)
Backgrounds: With the advancement of endovascular therapy for peripheral artery disease, thromboangiitis obliterans (TAO) patients might be able to benefit from endovascular therapy. We sought to investigate contemporary outcomes of endovascular therapy and intravascular ultrasound (IVUS) findings for TAO patients.
Methods: This study included 21 consecutive limbs in 17 patients (mean age, 47±8 years) undergoing endovascular therapy between April 2007 and February 2015. Subjects’ clinical symptoms included a broad spectrum such as critical ischemia and claudication in the lower and upper limbs.
Results: The extents of lesions were classified into crural type in 7, femorocrural type in 7, femoropopliteal type in 2, and radiopalmar/ulnopalmar type in 5. A total of 50 arteries and 1 graft were targeted. Successful revascularization was achieved in all limbs. Subacute thrombosis was observed in 4.8% (1 case) that was successfully managed by reintervention. Rutherford category significantly decreased after revascularization (Pre; 4.2±1.1, Post; 0.3±0.6, P<0.001). During a mean follow-up of 18.2±19.9 months (range, 2-96), clinical benefits was sustained although 29% (6 limbs) required a clinically-driven reintervention. IVUS optionally performed in 15 limbs revealed unique findings including “bulls-eye appearance”, “lotus-root appearance” and “grape branch appearance”. Out of a variety of IVUS findings, dissection and undulation yielded a trend toward a higher incidence of reintervention or reocclusion.
Conclusion: In our series, current endovascular therapy could serve as a potential option for TAO patients with lower and upper limb symptoms. Accumulating IVUS findings might lead to understand pathophysiology of TAO and predict the outcome of endovascular treatment.
Author Disclosures: O. Kawarada: Honoraria; Modest; Terumo, Boston Scientific, Cook, Johnson & Johnson, Kaneka Medics, Sanofi K.K., Otsuka, MSD K.K., Takeda Pharmaceutical Co., Ltd., Bayer Yakuhin, Ltd., Pfizer Japan Inc. T. Kume: None. K. Harada: None. T. Noguchi: None. H. Ogawa: Other Research Support; Modest; Astellas Pharma Inc, Bristol-Myers Squibb Company, Chugai Pharmaceutical Co, Ltd., Dainippon Sumitomo Pharma Co., Ltd., MSD K.K., Mochida Pharmaceutical Co., Ltd., Ono Pharmaceutical Co., Ltd., Otsuka, Pfizer Japan Inc, Takeda Pharmaceutical Co., Ltd.. Other Research Support; Significant; Bayer, Daiichi Sankyo Co., Ltd., Novartis Pharma K.K., Sanofi K.K.. Honoraria; Modest; AstraZeneca K.K., Boehringer Ingelheim Japan, Bristol-Myers Squibb Company, Mitsubishi Tanabe Pharma, Pfizer Japan Inc, Sanofi K.K., Teijin Pharma Co., Ltd. Honoraria; Significant; Bayer Yakuhin, Ltd., Daiichi Sankyo Co., Ltd., MSD K.K., Takeda Pharmaceutical Co., Ltd. S. Yasuda: Other Research Support; Modest; Takeda, Otsuka, Bristol-Myers, Boehringer Ingel. Honoraria; Modest; Takeda, Daiichi-Sankyo, Astra-Zeneca, Bristol-Myers.
- © 2015 by American Heart Association, Inc.