Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan.
Circ J. 2010 Aug;74(8):1684-8. doi: 10.1253/circj.cj-09-0878. Epub 2010 Jun 9.
A corkscrew collateral appearance on angiography is one of the diagnostic criteria for Buerger's disease. The purpose of the present study was to classify the angiographic findings of corkscrew collaterals and to evaluate the relationship between corkscrew collateral type and the severity of Buerger's disease.
Corkscrew collaterals were assessed on digital subtraction angiography in lower extremities of 28 patients with Buerger's disease (55 limbs). The corkscrew sign was classified into 4 types by size and pattern as follows: type I, artery diameter >2 mm, large helical sign; type II, diameter >1.5 mm and <or=2 mm, medium helical sign; type III, diameter >or=1 mm and <or=1.5 mm, small helical sign; and type IV, diameter <1 mm, tiny helical sign. The prevalence of ischemic ulcers was significantly higher in patients with types III and IV corkscrew collaterals than in patients with types I and II corkscrew collaterals either below or above the knee. Multiple regression analysis indicated that types III and IV below the knee are independent predictors of risk of ischemic ulcers.
The prevalence of ischemic ulcers is significantly higher in patients who have small corkscrew patterns in distal segments of limb collaterals than in patients who have large corkscrew collaterals.
血管造影上的螺旋状侧支外观是伯格氏病的诊断标准之一。本研究的目的是对螺旋状侧支的血管造影表现进行分类，并评估螺旋状侧支类型与伯格氏病严重程度之间的关系。
对 28 例伯格氏病患者（55 条肢体）下肢的数字减影血管造影进行了螺旋状侧支评估。根据大小和形态，螺旋征分为 4 型：I 型，动脉直径>2mm，大螺旋征；II 型，直径>1.5mm 且<=2mm，中螺旋征；III 型，直径>1mm 且<=1.5mm，小螺旋征；IV 型，直径<1mm，微小螺旋征。膝下 III 型和 IV 型螺旋状侧支患者的缺血性溃疡发生率明显高于膝上 I 型和 II 型螺旋状侧支患者。多元回归分析表明，膝下 III 型和 IV 型是缺血性溃疡发生的独立预测因子。
肢体侧支的远端存在小螺旋状形态的患者，其缺血性溃疡的发生率明显高于存在大螺旋状侧支的患者。
