Distribution of arterial involvement in thromboangiitis obliterans (buerger’s disease): Results of a study conducted by the Intractable Vasculitis syndromes research group in Japan

Abstract

The clinical profile of thromboangiitis obliterans (TAO) has been changing. The purpose of this study was to clarify the distribution of arterial involvement in this disease, based on a nationwide survey carried out in 1993. A total of 825 TAO patients with complete records were analyzed. There were 749 men and 76 women, with a mean age of 50.8 +/- 0.4 years. The survey assessed clinical manifestations categorized by Fontaine's classification, distribution of the lesions, associated diseases, responses to treatment, and outcome. This study focused on the distribution of arterial involvement. There were 42 patients (5.1%) with upper-extremity arterial involvement only, 616 (74.7%) with lower-extremity involvement only, and 167 (20.2%) with both. The most frequently affected arteries were the anterior (41.4%) or posterior (40.4%) tibial arteries in the lower extremities, and the ulnar artery (11.5%) in the upper extremities. There were no significant differences in the distribution of arterial involvement between men and women or between the right and left sides. In conclusion, approximately 25% of the patients had upper-extremity involvement. The anterior or posterior tibial arteries were most commonly affected. There was no significant difference in the distribution of arterial involvement between male and female patients.

Conservative treatment of patients with thromboangiitis obliterans or cannabis-associated arteritis presenting with critical lower limb ischaemia

“…[12] This concurs with the fi ndings of a large retrospective study by Sasaki et al (n = 825), where almost 75 % of patients with TAO showed exclusively lower extremity involvement. [13] Typical presentations are segmental arterial occlusions and corkscrew collaterals (Martorell sign) in DSA, as observed in our cases as well. However, contrary to popular belief, corkscrew collaterals are not pathognomonic for TAO [14].…”

Coexistence of axial spondyloarthritis and thromboangiitis obliterans in a young woman

“…Keeping into account the age of onset, smoking habit, the type, size and location of vasculitis, we ruled out the possibility of other diagnostic explanations in our patient, such as Takayasu arteritis (11,12). In agreement with the study of Sasaki et al, carried out to clarify the distribution of vasculitides in TAO, our patient presented vascular involvement of anterior and posterior tibial arteries in the lower extremities (9). Non erosive mono/oligoarthritis affecting large joints can occur up to 10 years before the first occlusive sign of TAO, often leading to a misinterpretation of the clinical phenotype (13).…”

“…Within a few weeks the patient reported a subjective improvement of coldness and rest pain: although the use of corticosteroids and sulfasalazine for the treatment of axial SpA is not supported by any evidence, the patient is currently treated with low-dose prednisone and salazopyrin, though a new biologic drug treatment has been proposed. TAO is a non-atherosclerotic vasculitis with a self-limiting course, characterized by inflammation of medium and smallsized arteries in the arms and legs, particularly radial and tibial arteries (9). Although its pathogenesis is not well understood, tobacco seems pivotal in the onset of this disease (2).…”

Thromboangiitis Obliterans (Buerger’s Disease)—Current Practices

“…TAO manifests as migratory thrombophlebitis or signs of arterial insufficiency in the extremities. In a study by Sasaki et al [26] the subjects were 749 men and 76 women, with a mean age of 50.8 ± 0.4 years. In 42 patients (5.1%) involvement was limited to upper extremity arteries, in 616 patients (74.7%) disease was limited to the lower extremity, 167 patients (20.2%) showed involvement of both upper and lower extremities.…”