[A case of Buerger's disease solitary involved in the left subclavian and axillary artery].

: A 26-year-old male with about a ten-year history of smoking was admitted to our hospital for evaluation of ischemic symptoms including numbness, easy fatigability on exercise and lack of pulse in his left arm. His left axillary, brachial and radial pulse could not be palpated and a needle reaction was negative on physical examination. Laboratory data showed no diabetes mellitus or hyperlipidemia. C-reactive protein, Wassermann's reaction, rheumatoid reaction, anti-nuclear factor, anti-DNA antibody, hypocomplementemia and circulating immune complex were negative. Invasive arteriography using contrast medium revealed segmental occlusion with multiple collateral arteries showing a typical "corkscrew" appearance at the left subclavian artery. However, no stenotic and aneurysm-like lesions suggesting aortitis syndrome, vasculo-Bechet disease and giant arteritis were found on the aorta or other arteries including the pulmonary artery. Although no pathological study could be carried out, the angiographic and laboratory findings strongly suggested Buerger's disease as a possible cause of solitary stenosis of the left subclavian artery in this patient.