The Infrapopliteal Arterial Occlusions Similar to Buerger Disease: Report of Two Cases

We herein present two cases that required the differential diagnosis of Buerger disease. Case 1 involved a 55-year-old male with a smoking habit who was admitted with ulcers and coldness in his fingers and toes. Angiography showed blockage in both the radial and posterior tibial arteries, which led to an initial diagnosis of Buerger disease. However, a biopsy of the right posterior tibial artery showed pathological findings of fibromuscular dysplasia (FMD). Case 2 involved a 28-year-old male with intermittent claudication who was examined at another hospital. Angiography showed occlusion of both popliteal and crural arteries, and the patient was suspected to have Buerger disease. However, computed tomography disclosed an abnormal slip on both sides of the popliteal fossa, and we diagnosed him with bilateral popliteal artery entrapment syndrome (PAES). These cases illustrate that other occlusive diseases, such as FMD and PAES, may sometimes be misdiagnosed as Buerger disease.

[1]  K. Eagle,et al.  The United States Registry for Fibromuscular Dysplasia: Results in the First 447 Patients , 2012, Circulation.

[2]  J. Olin,et al.  Diagnosis, management, and future developments of fibromuscular dysplasia. , 2011, Journal of vascular surgery.

[3]  J. Fiessinger,et al.  Thromboangiitis obliterans or Buerger's disease: challenges for the rheumatologist. , 2006, Rheumatology.

[4]  M. Koike,et al.  Oral bacteria in the occluded arteries of patients with Buerger disease. , 2005, Journal of vascular surgery.

[5]  K. Rerkasem,et al.  Decrease in the Incidence of Buerger's Disease Recurrence in Northern Thailand , 2005, Surgery Today.

[6]  T. Kwon,et al.  Mesenteric Involvement of Acute-Stage Buerger’s Disease as the Initial Clinical Manifestation: Report of a Case , 2005, Surgery Today.

[7]  N. Mekhail,et al.  Implantable spinal cord stimulator to treat the ischemic manifestations of thromboangiitis obliterans (Buerger's disease). , 1999, Journal of Vascular Surgery.

[8]  S. Shionoya Diagnostic criteria of Buerger's disease. , 1998, International journal of cardiology.

[9]  J. Olin,et al.  Thromboangiitis obliterans (Buerger's disease) , 2006, Current opinion in rheumatology.

[10]  T. Craven,et al.  Renal artery fibromuscular dysplasia: results of current surgical therapy. , 1995, Journal of vascular surgery.

[11]  J. Mills,et al.  Upper Extremity Ischemia Caused by Small Artery Disease , 1987, Annals of surgery.

[12]  S. Suzuki,et al.  Fibromuscular dysplasia in the extremities. , 1985, The Journal of cardiovascular surgery.

[13]  T. Yamada,et al.  Diagnostic and pathological considerations in the popliteal artery entrapment syndrome. , 1983, The Journal of cardiovascular surgery.

[14]  M. Mouquin [Thromboangiitis obliterans]. , 1954, La Revue du praticien.

[15]  K. F. Rogers Thromboangitis obliterans (Buerger's disease). , 1946, The Journal of the Canadian medical services.