Abstract
Coronary and internal thoracic artery involvement in the absence of peripheral arterial disease is rare, and histopathologic confirmation is even more uncommon. A 52-year-old man presented with 3-vessel disease. Further evaluation studies suggested diffuse coronary periarteritis. Coronary artery bypass grafting was performed with corticosteroid therapy. During surgery, the internal thoracic artery also showed signs of vasculitis, with marked intimal thickening, rendering it unsuitable as a graft. Intraoperatively, the intima of the coronary arteries was thickened and easily dissected using a coronary blower, resembling coronary endarterectomy. Histopathologic examination confirmed thromboangiitis obliterans, also known as Buerger disease.