Page 17 - Virtual Vascular Vol 4

Angiogram of this patient showed typical features of Buerger’s disease, with

segmental occlusive lesions of the small and medium-sized vessels and formation of
distinctive small collateral vessels around areas of occlusion, known as corkscrew

collaterals (arrowed), which are barely adequate for distal perfusion.
The second part of the Buerger’s test is to observe rubor on dependency with the
patient standing up or putting th elegs down from the side of the bed. The reactive

hyperaemia is due to dilatation of the arterioles as a result of vaso-active metabolites
that has accumulated in the extremity during elevation.

Note: Buerger’s test is not a diagnostic test for Buerger’s disease and can also be

positive in patients with severe lower limb ischemia from other causes.

16 17