Abstract:
Objective. This study describes a new technique for treatment of Buerger’s disease, developed to stimulate angiogenesis,
using a Kirschner wire placed in the medullary canal of the tibia. The aim of the study was to evaluate clinical and
radiological effects of this technique in patients where medical and surgical therapy had failed.
Material and methods. Eleven extremities (six patients) with Buerger’s disease were treated with the intramedullary
Kirschner wire technique. Inclusion criteria were chronic critical ischemia, Rutherford Grade II or III, with major arterial
occlusion shown by Doppler examination and angiography; failure to respond to non-surgical and surgical treatment; and
the need for strong analgesics.
Results. The mean follow-up time was 19 months (range, 13–25 months). Satisfactory remission in each patient was
obtained within 6 weeks of intervention. A significant improvement in clinical manifestations including reduced rest pain
and increased claudication distance was observed. Foot ulcers completely healed after Kirschner wire intervention.
Conclusion. Despite short-term follow-up and small patient series, the intramedullary Kirschner wire technique can be
expected to achieve relief of pain and a decrease in major amputations in patients with Buerger’s disease in whom medical
and surgical therapy had failed. However, comparative studies with longer follow-up should be done to confirm the benefits of
this new treatment.
