Classification of Corkscrew Collaterals in Thromboangiitis Obliterans (Buerger's Disease) – Relationship Between Corkscrew Type and Prevalence of Ischemic Ulcers –

Yuichi Fujii; Junko Soga; Shuji Nakamura; Takayuki Hidaka; Takaki Hata; Naomi Idei; Noritaka Fujimura; Kenji Nishioka; Kazuaki Chayama; Yasuki Kihara; Yukihito Higashi

doi:10.1253/circj.CJ-09-0878

Peripheral Artery Disease

Classification of Corkscrew Collaterals in Thromboangiitis Obliterans (Buerger's Disease)

– Relationship Between Corkscrew Type and Prevalence of Ischemic Ulcers –

Yuichi Fujii, Junko Soga, Shuji Nakamura, Takayuki Hidaka, Takaki Hata, Naomi Idei, Noritaka Fujimura, Kenji Nishioka, Kazuaki Chayama, Yasuki Kihara, Yukihito Higashi

Author information

Yuichi Fujii
Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences
Junko Soga
Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences
Shuji Nakamura
Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences
Takayuki Hidaka
Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences
Takaki Hata
Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences
Naomi Idei
Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences
Noritaka Fujimura
Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences
Kenji Nishioka
Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences
Kazuaki Chayama
Department of Medicine and Molecular Science, Hiroshima University Graduate School of Biomedical Sciences
Yasuki Kihara
Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences
Yukihito Higashi
Department of Cardiovascular Physiology and Medicine, Hiroshima University Graduate School of Biomedical Sciences

Keywords: Buerger's disease, Corkscrew collateral, Ischemic ulcer

JOURNAL FREE ACCESS

2010 Volume 74 Issue 8 Pages 1684-1688

DOI https://doi.org/10.1253/circj.CJ-09-0878

View "Advance Publication" version (June 9, 2010).

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Abstract

Background: 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. Methods and Results: 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 ≤2 mm, medium helical sign; type III, diameter ≥1 mm and ≤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. Conclusions: 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. (Circ J 2010; 74: 1684 - 1688)

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