Thromboangiitis obliterans (Buergerʼs disease)

Olin, Jeffrey W.; Shih, Anthony

doi:10.1097/01.bor.0000198000.58073.aa

Cited by 144 publications

(45 citation statements)

References 45 publications

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“…Angiography is essential for making an accurate diagnosis of Buerger disease. Typical arteriographic findings, such as abrupt or tapering occlusion, corkscrew collaterals, and the absence of calcification, provide supporting evidence for a diagnosis of Buerger disease [7]. Biopsy and tissue sampling are rarely needed to confirm the diagnosis of Buerger disease; however, in rare cases with an unusual onset of symptoms, the histopathological findings are useful for making the definitive diagnosis [8].…”

Section: Discussionmentioning

confidence: 99%

The Infrapopliteal Arterial Occlusions Similar to Buerger Disease: Report of Two Cases

Igari

Kudo

Toyofuku

et al. 2014

Case Reports in Vascular Medicine

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We herein present two cases that required the differential diagnosis of Buerger disease. Case 1 involved a 55-year-old male with a smoking habit who was admitted with ulcers and coldness in his fingers and toes. Angiography showed blockage in both the radial and posterior tibial arteries, which led to an initial diagnosis of Buerger disease. However, a biopsy of the right posterior tibial artery showed pathological findings of fibromuscular dysplasia (FMD). Case 2 involved a 28-year-old male with intermittent claudication who was examined at another hospital. Angiography showed occlusion of both popliteal and crural arteries, and the patient was suspected to have Buerger disease. However, computed tomography disclosed an abnormal slip on both sides of the popliteal fossa, and we diagnosed him with bilateral popliteal artery entrapment syndrome (PAES). These cases illustrate that other occlusive diseases, such as FMD and PAES, may sometimes be misdiagnosed as Buerger disease.

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Section: Discussionmentioning

confidence: 99%

The Infrapopliteal Arterial Occlusions Similar to Buerger Disease: Report of Two Cases

Igari

Kudo

Toyofuku

et al. 2014

Case Reports in Vascular Medicine

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“…The sample included eight patients with TA recruited at three hospitals in Barcelona (Spain), all fullfiling the diagnostic criteria proposed by Olin et al [1,2] and Shinoya et al [16] : onset before the age of 50 years; current (or recent past) tobacco use; distal extremity ischemia (infrapopliteal and/or intrabrachial), such as claudication, rest pain, ischemic ulcers, and gangrene documented with noninvasive testing; exclusion of connective tissue diseases and hypercoagulable states; exclusion of a proximal source of emboli with echocardiography and arteriography; and consistent arteriographic findings in the involved and clinically uninvolved limbs including multiple segmental occlusions of distal arterial sections (distally from the elbow and knee); chronic vascular occlusion due to secondary thrombosis; absence of atherosclerotic lesions, such as calcification of vascular walls; tapering and abrupt obstruction of vessels, a twisting course of the involved vessels; and “corkscrew” or “tree-root” collaterals.…”

Section: Methodsmentioning

confidence: 99%

“…[1,2] It affects the small and medium-sized arteries and veins in the upper and lower extremities. Symptoms generally begin with coldness of the fingers and toes, and intermittent claudication, then progress to ischemic pain at rest, and ultimately result in the development of ischemic ulcerations and gangrene that can necessitate amputation.…”

Section: Introductionmentioning

confidence: 99%

“…[1,2] In addition to the discontinuation of tobacco, very few pharmacological and surgical options of controversial efficacy are available to date. Different treatments such as antiplatelet agents, anticoagulants, and vasodilators (including calcium channel blockers, pentoxyfylline, and cilostazol) are widely used, although there is no proven evidence of their palliative benefits.…”

Section: Introductionmentioning

confidence: 99%

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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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“…12 Selective antagonists of cannabinoid receptors, such as rimonabant, open up new perspectives in the treatment of this smokingrelated disease. 13 One new approach involves the induction of angiogenesis using genetic transfer techniques.…”

Section: Conservative Therapeutic Strategiesmentioning

confidence: 99%

Spinal Cord Stimulation for the Treatment of Buerger Disease

Fabregat-Cid

Villanueva²,

Asensio³

et al. 2011

The Clinical Journal of Pain

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Spinal cord stimulation is an accepted therapy for the treatment of chronic ischemic pain and ulcer healing and to avoid amputation in patients with severe, nonrevascularisable peripheral occlusive arteriopathy, and specially in the subgroup of patients with Buerger disease. It should not only be considered as a last resort strategy for pain control, but as a valid therapeutic option to improve perfusion of the limbs in the initial stages of the disease, however larger studies still remain necessary.

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Thromboangiitis obliterans (Buergerʼs disease)

Cited by 144 publications

References 45 publications

The Infrapopliteal Arterial Occlusions Similar to Buerger Disease: Report of Two Cases

The Infrapopliteal Arterial Occlusions Similar to Buerger Disease: Report of Two Cases

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

Spinal Cord Stimulation for the Treatment of Buerger Disease

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