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Controversy continues over the clinical concept of Buerger's disease. Although clinical and radiological criteria exist to prove the diagnosis and most clinicians acknowledge this disease, there is the question of possible cases of Buerger's disease where the criteria cannot be met. Should these cases be referred to as Buerger's syndrome? In order to elucidate this question, we analysed 12 recent cases (1% of all our cases of vascular disease). In 6 cases (50%) the clinical and diagnostic criteria of Buerger's disease were met fully; in 4 (32%) the clinical picture favoured Buerger's syndrome; in another 2 patients the clinical picture was that of Buerger's syndrome but the arteriograms showed signs of atheroma. Eight of the 12 patients underwent sympathectomy. One patient, considered to have visceral and cerebral involvement, died.