Becquemin J P, Mellière D, Gallon J P, Vo Dinh J, Lange F
J Mal Vasc. 1983;8(2):183-8.
Sixty-three patients with arteriopathies confirmed by arteriography when they were under 40 years of age were followed up for between 1 and 7 years. The arteriopathy was due to atheroma in 23 cases, to miscellaneous in 22 cases, and to Buerger's disease less frequently (18 cases), suggesting that atheroma should be suspected as being at the origin of an arteriopathy initially in young subjects. Confirmation of the basic nature of the affection is based on several criteria, the most reliable being results of angiography and the detection of associated lesions in other localizations. Histology is a decisive element, but biopsy may involve risks and results are sometimes difficult to interpret. Treatment depends more on clinical symptomatology and the localizations of arterial occlusion than on the nature of the arteriopathy. Sympathectomy is effective in distal lesions, whereas revascularization, adapted to the often small size of the vessels involved and potential impairment in distal vessel circulation, is necessary for proximal lesions. Overall prognosis is more satisfactory in Buerger's disease than in arteriopathy of atheromatous origin, rapid progression occurring in half of the latter cases.
63例40岁以下经动脉造影确诊为动脉病变的患者接受了1至7年的随访。23例动脉病变是由动脉粥样硬化引起，22例是由其他杂症引起，由血栓闭塞性脉管炎引起的较少（18例），这表明在年轻患者中，最初应怀疑动脉粥样硬化是动脉病变的根源。对疾病基本性质的确认基于几个标准，最可靠的是血管造影结果和在其他部位检测到的相关病变。组织学是一个决定性因素，但活检可能有风险，而且结果有时难以解释。治疗更多地取决于临床症状和动脉闭塞的部位，而不是动脉病变的性质。交感神经切除术对远端病变有效，而血管重建术，由于所涉及的血管通常较小以及远端血管循环可能受损，对于近端病变是必要的。血栓闭塞性脉管炎的总体预后比动脉粥样硬化性动脉病变更令人满意，后者有一半病例会迅速进展。
