Arteriographic findings in Thromboangiitis Obliterans
Although no single arteriographic feature is specific for TO, the radiographic constellation in conjunction with the clinical picture is diagnostic. On arteriograms, there is involvement of the small- and medium-sized blood vessels, most commonly the digital arteries of the fingers and toes as well as the palmar, plantar, tibial, peroneal, radial, and ulnar arteries. The angiographic appearance is bilateral focal segments of stenosis or occlusion with normal proximal or intervening vessels. An increase in collateral vessels often occurs around areas of occlusion, giving a tree-root, spider-web, or corkscrew appearance. Note that in the arteriographic description, the affected arteries may have normal segments, but most important is that the proximal arteries are normal, without the evidence of atherosclerosis or emboli.