Congenital arteriopathies and Leo Buerger's disease
Latour, H.; Rénevier, D.; Ferrière, M.; Caula, J.M.; Bosc, E.; Boureux, C.; Bellouvet, M.
Archives des Maladies du Coeur et des Vaisseaux 72(3): 284-295
1979
ISSN/ISBN: 0003-9683 PMID: 114139 Document Number: 146405
A homogenous series of 7 consecutive cases of Buerger's disease were investigated and the congenital malformations of the upper and lower limb arterial trunks were classified. These malformations constitute the anatomical basis of Buerger's disease and define an autonomous disease entity. Total supra-malleolar interruption of the main lower limb arteries either by triple vessel agenesis or, more rarely, by femoro-popliteal or popliteal and tibio-peronal agenesis was observed. The appearances of the collateral circulation, already established in utero, are characteristic with long axial spiral-shaped arteries and dependant arterioles maintaining a precarious supply to the distal tissues which may be adequate for many years. The nautral history of the disease is directly related to the malformation of the congenital arterial system of the limbs. Proximal arterial malformative occlusion is the cause of early, inevitable trophic lesions; the spiral-shaped arteries and distal arterioles, which represent the maximal embryonic collateral circulation, limit the area of necrosis and favour healing.