Are we still seeing Buerger's disease (TAO)?

we used to see more patients with gangrenous tips due to excessive smoking in young people 15 years back. Then slowly the number of such patients attending our clinic slowly decreased. But in the recent past again we are finding more of them coming to our clinics. It is probably due to the Aarogyasri scheme which is providing them financial support to come to the big hospitals for special care. The disease presentation in the hospitals is dependent on many aspects and one may get misguided if the disease presentation is not understood. Buerger's disease still persists in our low socioeconomic group of people.

Synthetic graft for replacing the diseased common femoral artery and superficial femoral artery in the groion with implantation of the profunda femoris artery.

Young smokers usually present to the vascular clinics from the rural areas with disease below the knee and above the knee. Such patients may need repair of the thigh blood vessels with poor distal runoff below the knee. One would be heistantly usin the synthetic grafts in them as there is no other alternative to the diseased veins (graft). In such cases we feel it is very important to make sure the profundafemoris branch is revascularised (with or without endarterectomy) by reimplanting it in to the synthetic graft. This will probably help also in improving the patency of the synthetic graft. This video was taken after completion of the operation where the profunda is attached to the graft ( hidden) in graft bed.

Pinjal R K '09