Thromboangiitis obliterans (Buerger's disease) in a saphenous vein arterial graft

Thromboangiitis obliterans (Buerger's disease) is an uncommon variety of occlusive peripheral vascular disease, occurring predominantly in young male tobacco smokers. The vascular lesion in the acute stage of thromboangiitis obliterans is distinctive and affects both the arteries and veins. Described here is an unusual case of thromboangiitis obliterans occurring in a saphenous vein used for coronary artery bypass graft in a middle-aged man who, against advice, had continued to smoke after the myocardial revascularization surgery. To the author's knowledge, thromboangiitis obliterans in arterial vein graft has not been reported previously.