Thromboangiitis obliterans

Disease class: Vasculitis

Also known as Buerger disease.

 

Symptoms

• Intermittent claudication 
• Pain at rest
• Increased cold sensitivity
• Ulceration

 

Signs

• Diminished peripheral pulses
• Skin changes
• Discolouration
• Red-blue discolouration
• Cyanosis
• Reduced hair growth
• Gangrenous necrosis

 

Pathophysiology 

The cause is currently unknown, but affected patients are usually current or former tobacco smokers. It is believed to be an autoimmune response.
Rickettsia infection may be involved in the pathogenesis.

 

Risk factors

• Tobacco smoking 

 

Epidemiology

• Typically between 20–40 years old and male. Females have also been diagnosed.

Complications

• Critical limb ischaemia
• Sepsis 

 

Management

• Smoking cessation reduces rate of progression and severity of outcomes.
• Hyperbaric medicine
• Vasodilators
• Sympathectomy
• Vascular bypass
• Debridement
• Excision
• Amputation

Anti-inflammatory and anti-coagulation therapies have not proven beneficial.