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Thromboangiitis Obliterans (Buerger Disease)

Franklyn C. Babb, FAAFP, MD Reviewed 06/2021
 


BASICS

DESCRIPTION

  • A cause of critical limb ischemia

  • Nonatherosclerotic vasculitis of small- and medium-sized arteries and veins resulting in segmental occlusion of the distal extremity vasculature; cau...

DIAGNOSIS

  • Point scoring systems are available to clarify clinical diagnosis. Two are most referenced:

    • Shionoya criteria:

      • Smoking history

      • Onset <50 years of age

      • Infrapopliteal arterial occlusions

      • Either ...

TREATMENT

GENERAL MEASURES

  • Tobacco cessation (mandatory)

  • Eliminate other vasoconstrictive triggers (cold/drugs).

  • Eliminate exposure to chemical damage (e.g., iodine, carbolic acid, salicylic acid).

  • Avoid ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Use a bed cradle (nonheated) to prevent pressure from bed linens. 

Patient Monitoring

Ensure tobacco cessation and monitor for recurrence. 

PATIENT EDUCATION

  • Avoid pr...

REFERENCES

1
Piazza  G, Creager  MA. Thromboangiitis obliterans. Circulation.  2010;121(16):1858–1861. [View Abstract on OvidMedline]
2
...

ADDITIONAL READING

  • Abeles  AM, Nicolescu  M, Pinchover  Z, et al. Thromboangiitis obliterans successfully treated with phosphodiesterase type 5 inhibitors. Vascular.  2...

CODES

ICD10

I73.1 Thromboangiitis obliterans [Buerger’s disease] 

SNOMED

  • 52403007 Thromboangiitis obliterans (disorder)

  • 230601003 Neuropathy in thromboangiitis obliterans (disorder)

CLINICAL PEARLS

  • Tobacco cessation is mandatory in patients with TAO. Tobacco cessation decreases the risk of amputation. Nicotine replacement therapy may sustain disease activity.

  • Urinary nicotine and ...

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