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Thromboangiitis Obliterans (Buerger Disease)

Franklyn C. Babb, MD, FAAFP Reviewed 06/2018
 


BASICS

DESCRIPTION

  • One of the causes of critical limb ischemia

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

DIAGNOSIS

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

  • Shionoya criteria:

    • Smoking history

    • Onset <50 years of age

    • Infrapopliteal arterial ...

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
Weinberg I, Jaff MR. Nonatherosclerotic arterial disorders of th...

ADDITIONAL READING

  • Abeles AM, Nicolescu M, Pinchover Z, et al. Thromboangiitis obliterans successfully treated with phosphodiesterase type 5 inhibitors. Vascular.  2014;22(4):313–316.

  • Dargon PT, L...

CODES

ICD10

I73.1 Thromboangiitis obliterans [Buerger's disease] 

ICD9

443.1 Thromboangiitis obliterans [Buerger's disease] 

SNOMED

  • 52403007 Thromboangiitis obliterans (disorder)

  • 230601003 Neuropathy in thr...

CLINICAL PEARLS

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

  • Urinary nicotine and c...

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