Abstract
Buerger disease or thromboangiitis obliterans is a non-atherosclerotic, segmental, inflammatory, peripheral arterial occlusive disease in young male smokers. Revascularization via endovascular treatment and/or bypass surgery is less common and is technically challenging in patients with Buerger disease. Herein, we report the case of a 30-year-old male patient who underwent endovascular treatment followed by bypass surgery, which successfully salvaged his critically ischemic limbs. This case demonstrates that a revascularization strategy for critical limb ischemia due to Buerger disease could be beneficial for limb salvage. To achieve effective limb salvage, a collaborative approach among endovascular specialists, vascular surgeons, and reconstructive surgeons is recommended.
After the bypass surgery, the ischemic necrosis site gradually became clear (A), and patchy skin necrosis was found over a wide area of the left planta (B). (C) The skin color of the foot improved daily, and most of the necrotic tissue at the proximal level of the metatarsophalangeal joint was peeled off.
https://ror.org/00ew91p29 
