What are corkscrew-shaped collaterals indicative of on an angiogram?

Corkscrew-shaped collaterals seen on an angiogram are indicative of Buerger's disease, also known as thromboangiitis obliterans. This condition primarily affects small and medium-sized blood vessels in the arms and legs, leading to vascular inflammation and occlusion. The distinct corkscrew appearance arises due to the development of collateral circulation as the body attempts to bypass the obstructed areas, resulting from the inflammatory process and thrombus formation in the affected vessels.

In Buerger's disease, patients often present with symptoms such as claudication, rest pain, and even necrotic changes in the fingers or toes, which can be visualized through such angiographic findings. The presence of these collaterals is a hallmark that helps distinguish Buerger's from other vascular conditions, which may present differently on imaging studies.

Other conditions listed, such as polyarteritis nodosa and Wegener's granulomatosis, can also affect blood vessels and lead to complications, but they do not typically produce the characteristic corkscrew configuration of collateral circulation seen in Buerger's disease. Avascular necrosis is related to the loss of blood supply to bone tissue rather than the development of abnormal angiographic patterns in peripheral vessels