Fazeli Bahare, Poredos Pavel, Liew Aaron, Stephen Edwin, Bashar Abul Hasan Muhammad, Kozak Matija, Catalano Mariella, Al Salman Mussaad Mohammaed, Altarazi Louay, Antignani Pier Luigi, Desai Sanjay, Dimakakos Evangelos, Erer Dilek, Farkas Katalin, Fokou Marcus, Hussein Emad, Ionac Mihai, Iwai Takehisa, Karahan Oguz, Kashani Daniel, Kota Albert, Kroger Knut, Kubat Emre, Kumar Prabhu Prem, Malecki Rafal, Marcoccia Antonella, Pandey Sandeep Raj, Patel Malay, Pecsvarady Zsolt, Polat Adil, Ravari Hassan, Schernthaner Gerit, Selvaraj Dheepak, Sharebiani Hiva, Stanek Agata, Szuba Andrzej, Taha Wassila, Taheri Hossein, Yuwono Hendro Sudjono, Zor Mustafa Hakan
Support Association of Patients of Buerger's Disease (Buerger's Disease NGO), Mashhad 9183785197, Iran.
Department for Vascular Diseases, Medical Faculty of Ljubljana, University Medical Center Ljubljana, 1000 Ljubljana, Slovenia.
J Clin Med. 2025 Jul 8;14(14):4841. doi: 10.3390/jcm14144841.
In 2023, the VAS international working group on Buerger's Disease (BD) recommended two diagnostic criteria based on a prior Delphi study: "definitive" and "suspected". The "definitive" criteria are history of smoking, typical angiography, and typical histopathological features. All three features are mandatory to confirm a "definitive" diagnosis of BD. The conundrum is-what features should be considered typical of BD angiography? According to this review, segmental occlusion of infrapopliteal arteries, corkscrew collaterals that appear to continue the occluded arterial segment (Martorell's sign) or bypass the segmental occlusion, absence of atherosclerotic plaque or aneurysm could differentiate BD from ASO. Hence, for "typical" BD angiography, these manifestations should certainly be considered. However, data for differentiating angiography patterns of BD from the small- and medium-sized vasculitis including Behcet's disease, scleroderma, hepatitis associated vasculitis, and anti-phospholipid syndrome are limited. Further studies for investigating the angiography pattern in BD patients in early and late presentation of BD, particularly in the patients with long-term follow up, are highly recommended.
2023年，血管炎国际血栓闭塞性脉管炎（BD）工作组基于之前的德尔菲研究推荐了两种诊断标准：“确诊”和“疑似”。“确诊”标准包括吸烟史、典型血管造影表现和典型组织病理学特征。所有这三个特征都是确诊BD“确诊”诊断所必需的。难题在于——哪些特征应被视为BD血管造影的典型特征？根据本综述，腘动脉以下动脉节段性闭塞、似乎延续闭塞动脉段的螺旋状侧支循环（马托雷尔征）或绕过节段性闭塞的侧支循环、无动脉粥样硬化斑块或动脉瘤可将BD与动脉硬化闭塞症区分开来。因此，对于“典型”BD血管造影，这些表现当然应予以考虑。然而，区分BD血管造影模式与包括白塞病、硬皮病、肝炎相关性血管炎和抗磷脂综合征在内的中小血管炎的血管造影模式的数据有限。强烈建议进一步开展研究，以调查BD早期和晚期患者，尤其是长期随访患者的血管造影模式。
