Thromboangiitis Obliterans (Buerger’s Disease)—Current Practices

Vijayakumar, Abhishek; Tiwari, Rahul Vc; Prabhuswamy, Vinod Kumar

doi:10.1155/2013/156905

Cited by 83 publications

(135 citation statements)

References 53 publications

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“…A problem in the treatment of TAO is that the disease can remain active and progress despite stopping smoking. TAO patients have an alteration of vasorelaxation dependent on endothelium in the peripheral vasculature . Another major difficulty lies in the difficulty of these patients to give up smoking .…”

Section: Discussionmentioning

confidence: 99%

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Treatment of thromboangiitis obliterans (Buerger's disease) with high-potency vasodilators

et al. 2015

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Thromboangiitis obliterans (TAO) or Buerger's disease is a vascular inflammatory thrombotic occlusive and segmental disease affecting distal small and medium-sized arteries of the limbs. Tobacco is the main trigger factor and avoiding it is the main treatment. Frequently, it is necessary to use high-potency vasodilators, such as iloprost, bosentan, sildenafil, or alprostadil, to relieve symptoms and reduce the risk of amputation. Iloprost is the only one that has been shown to be effective in randomized clinical trials. We report the third case of TAO treated with sildenafil and a new case treated with bosentan. This condition can be diagnosed and treated by a dermatologist. We would like to highlight the excellent clinical response despite the fact that patients continued to smoke. This finding may have important therapeutic implications because early treatment may prevent amputation and can be effective even during the process of giving up smoking.

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Section: Discussionmentioning

confidence: 99%

“…Segmental occlusive lesions of the small and medium-sized arteries with formation corkscrew collaterals and abrupt occlusion of an otherwise normal artery are typical angiographic findings in TAO. A biopsy is rarely indicated (1,3,5). These patients have a high risk of death and amputation (2).…”

Section: Discussionmentioning

confidence: 99%

Treatment of thromboangiitis obliterans (Buerger's disease) with high-potency vasodilators

et al. 2015

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“…[4,9–15,17] After evaluation of the full text, 2 of these articles were excluded because they were reviews. [4,17] In addition, we excluded 7 of the 19 cases reported by De Haro et al [11] because their clinical characteristics were not sufficiently detailed to be individually analyzed.…”

Section: Methodsmentioning

confidence: 99%

Efficacy of bosentan in patients with refractory thromboangiitis obliterans (Buerger disease)

Narváez¹,

García-Gómez²,

Álvarez

et al. 2016

Medicine

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The cornerstone of therapy in thromboangiitis obliterans (TAO) is complete abstinence from tobacco. In addition to discontinuation of cigarette smoking, very few pharmacological and surgical options of controversial efficacy are available to date. New therapeutic options with greater efficacy are clearly needed to properly manage these patients.In this preliminary study, we assessed the effectiveness and safety of bosentan in a case series of 8 adults with TAO and severe ischemic ulceronecrotic lesions who were treated with bosentan after inadequate response to platelet inhibitors, vasodilators, and intravenous alprostadil. Additionally, we reviewed 18 well-documented patients with refractory TAO treated with bosentan, which was previously reported (PubMed 1965–2015). These 26 patients formed the basis of our present analysis. All were current smokers.The median duration of bosentan treatment (SD) was 4.5 ± 4 months (range 3–16). Eleven patients (42%) were unable to completely abstain from smoking during their follow-up. With bosentan treatment, no new ischemic lesions were observed in the target extremities. A complete therapeutic response was achieved in 80% of patients, whereas a partial response was observed in 12%. Two patients (8%) ultimately required amputation despite treatment.After discontinuation of bosentan, patients were followed for a median of 20 ± 14 months (range 3–60). Two patients whose trophic lesions had healed relapsed.When comparing patients who gave up smoking with those who were unable to completely abstain from smoking during follow-up, no significant differences were found in efficacy outcomes. Four patients (15%) developed adverse events, requiring bosentan discontinuation in 1 case.These preliminary data suggest that bosentan may be considered a therapeutic option for treatment of cases of severe TAO refractory to conventional treatment, and merit further evaluation in larger controlled, randomized clinical studies.

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“…1 Although the exact underlying causes of Buerger's disease are still unknown, the disease is strongly associated with tobacco smoking. 2 The disease is more prevalent in India, Southeast Asia and eastern European countries than the West. …”

Section: Introductionmentioning

confidence: 99%

Buerger’s disease in female: rare case report

et al. 2018

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Thromboangiitis obliterans (Bureger’s disease) is a vascular disease characterized by a segmental, non-atherosclerotic inflammation of the small and medium-sized arteries and veins of the distal extremities mostly affecting young male smokers and rarely females. Only a few cases with histologic proof of the disease in females have ever been recorded in literature. We report a rare case of Buerger’s disease in a 55 years old female.

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Thromboangiitis Obliterans (Buerger’s Disease)—Current Practices

Cited by 83 publications

References 53 publications

Treatment of thromboangiitis obliterans (Buerger's disease) with high-potency vasodilators

Treatment of thromboangiitis obliterans (Buerger's disease) with high-potency vasodilators

Efficacy of bosentan in patients with refractory thromboangiitis obliterans (Buerger disease)

Buerger’s disease in female: rare case report

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