Shionoya S, Ban I, Nakata Y, Matsubara J, Hirai M, Kawai S
J Cardiovasc Surg (Torino). 1980 Jan-Feb;21(1):77-84.
Forty of 266 patients with Buerger's disease underwent 47 vascular reconstructions: bypass in 38, thromboendarterectomy in 7 and replacement in 2. Indications for arterial reconstruction were ulceration or gangrene in 60%, claudication in 33.3% and rest pain in 6.7%. In a follow-up from 6 months to 8 years and 7 months, the overall patency rate was 24% in bypass, 0% in thromboendarterectomy and 100% in replacement. One hundred nine of the 266 patients underwent sympathetic denervation: lumbar in 92 (bilateral in 19) and thoracic in 17. In the course of 11 years follow-up study, 23 cases required amputation of the extremity. A good initial result gradually gave way to recurrence unless the patients discontinued smoking. The most important factor which decides natural history of Buerger's disease is smoking.
266例血栓闭塞性脉管炎患者中有40例接受了47次血管重建手术：38例进行了旁路移植术，7例进行了血栓内膜切除术，2例进行了血管置换术。动脉重建的指征为溃疡或坏疽占60%，间歇性跛行占33.3%，静息痛占6.7%。在6个月至8年7个月的随访中，旁路移植术的总体通畅率为24%，血栓内膜切除术为0%，血管置换术为100%。266例患者中有109例接受了交感神经切除术：92例为腰交感神经切除术（19例为双侧），17例为胸交感神经切除术。在11年的随访研究过程中，23例患者需要截肢。除非患者戒烟，否则良好的初始结果会逐渐复发。决定血栓闭塞性脉管炎自然病程的最重要因素是吸烟。
