) أ.م.د. احمد عبداالمير دفار ( اختصاصي جراحة الصدر و القلب و االوعية الدموية
1
Thromboangiitis obliterans
(Buerger's disease)
Objective : To show the definition, etiology and management
of Thromboangiitis
obliterans (Buerger's disease)
.
Etiology
There is a very strong association with smoking
Clinical manifestations
Thromboangiitis obliterans typically occurs in heavy smokers between 20 and 35 years of age of
both sexes. Unlike in atherosclerosis, the upper extremities are often involved and there is
frequently a history of migratory superficial phlebitis. Associated symptoms include Raynaud's
phenomenon & foot claudication is particularly characteristic.
Exacerbations with smoking and remissions after abstinence from tobacco are typical of
thromboangiitis obliterans.
Treatment
- Smoking should be stopped
- Relief of pain using narcotics.
- Dorsal or lumbar sympathectomy.
- Anticoagulants
- Antiplatelets
- Pentoxifylline
- Arterial reconstruction is usually impossible because of the distal nature of the disease.
- When gangrene occurs, amputation at the lowest possible level is indicated.