What Is Thromboangiitis Obliterans?

Thromboangiitis vasculitis is a rare chronic recurrent segmental inflammatory disease of the middle and small arteries and veins. It is more common in the lower extremities. It is manifested as ischemia, pain, intermittent claudication, weakened or disappeared dorsal foot arteries, and migrating superficial phlebitis. In severe cases, there are extremity ulcers and necrosis.

Basic Information

English name
thromboangiitis obliterans
English alias
Buerger disease
Visiting department
Vascular surgery
Multiple groups
Young people
Common locations
Lower limb
Common causes
Arterial spasm and thrombosis cause occlusion resulting in ischemia
Common symptoms
Ischemic limb pain, pain, intermittent claudication, weakened dorsal foot pulse
Contagious
no

Causes of thrombo-occlusive vasculitis

It is currently believed that the disease is due to arterial spasm and thrombosis, resulting in ischemia. Half of them are accompanied by Raynaud's phenomenon, which is more common in men and more in smokers. Smoking is closely related to the course and prognosis of the disease.

Clinical manifestations of thrombo-occlusive vasculitis

The disease is more common in young adults and occurs in the lower extremities. The affected limb showed temporary or persistent paleness, cyanosis, burning and stinging, the skin color of the affected limb became red when it drooped, and it turned white when lifted, followed by numbness of the toes, pain in the calf muscles, excitement during walking, and disappeared at rest ; Superficial phlebitis and edema often occur in the lower leg. On examination, the dorsal foot artery pulsation weakened or disappeared. With the development of the disease, intermittent claudication and Raynaud's phenomenon, increased pain at night, severe toe pain, cyanosis of the skin, and blackening of the ulcer or gangrene at the toe end gradually spread to the proximal end.

Diagnosis of thrombo-occlusive vasculitis

According to the patient's limbs with paroxysmal pain, intermittent claudication, weakened or disappeared dorsal foot arterial pulse, escorting superficial phlebitis can be diagnosed.
It should be distinguished from occlusive arteriosclerosis. The latter are over 40 years of age and are often accompanied by hypertension, diabetes, hyperlipidemia, and coronary atherosclerotic heart disease. The large and middle arteries are often involved, and the course of the disease develops rapidly. X-rays or color Doppler ultrasound of the blood vessels can indicate calcification in the arterial wall of the affected limb.

Thrombo-occlusive vasculitis treatment

Drug treatment
(1) Dextran-40 is intravenously infused with dextran with a molecular weight of 5000 to 20,000. Long-term application may cause bleeding, and it should not be applied to patients with acute development and secondary infection of ulcer and gangrene.
(2) Vasodilators Tolasurin hydrochloride, nicotinic acid, benzylamine hydrochloride, etc. can be used.
(3) Antibiotics For patients with local and systemic infections, use appropriate antibiotics for treatment.
(4) Glucocorticoids For the acute phase of the disease can be considered for application, daily oral prednisone or intravenous infusion of hydrocortisone.
(5) Analgesics: Those with obvious pain can choose various analgesics, or use procaine acupoint injection, vein closure or femoral artery closure, even lumbar sympathetic ganglia block or epidural anesthesia.
(6) Local treatment Sterile dressing for dry gangrene to prevent infection, and new dressings for external healing of ulcers.
2. Surgical treatment
Lumbar sympathectomy, great saphenous vein transplantation or arterial thromboendometrial ablation can be used for non-surgical treatment of ineffective patients. After the acrotic necrosis boundary is limited, it is expanded under sterile conditions to remove necrotic tissue. For those who have formed gangrene at the tip of the finger (toe), we should consider cutting the finger (toe).

Thrombo-occlusive vasculitis prevention

No smoking. Protect your feet from cold and humidity, avoid trauma, and prevent vasospasm of the limbs. Proper change of body position during work to prevent long-term compression of blood vessels in the limbs and affect blood circulation.

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