Buerger's Disease / Thromboangitis obliterans Flashcards Preview

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Flashcards in Buerger's Disease / Thromboangitis obliterans Deck (11):
1

What is thromoboangitis obliterates?

Inflammatory occlusive thrombosis of small and medium sized arteries and some superficial veins usually in the distal and upper extremities

2

Who is affected by TO?

-Occurs almost exclusively in tobacco users
-Usu males 20-40y
-Asia, Far East, Middle East

3

Which genotypes are associated with TO?

HLA-A9
HLA-B5

4

What occurs in acute thromboangitis obliterates?

-occlusive thrombi accompany neutrophilic and lymphocytic infiltration of intima
-endothelial cells proliferate
-internal elastic lamina remains intact

5

What occurs in intermediate TO?

Thrombi organise and reconciles incompletely.
-media preserved but may be infiltrated by FBs

6

What causes TO?

Exact mechanisms unkown:
-cigarette smoking primary risk factor
-may involve DTH or toxic angitis or
-cell mediated sensitivity to collagen I and III (in blood vessels)

7

What are the CFx of TO?

Triad of:
-claudication of affected extremity (+/- trophic / ischaemic changes)
-Raynaud's
-migratory superficial thrombophlebitis

8

Where does claudication occur in TO and why?

-Lower calves and feet
-forearms and hands
TO affects distal vessels

9

What is demonstrated on angiography in TO?

-segmental occlusion of distal arteries of hands and feet
-torturous, corkscrew collateral vessels around occlusions
-no atherosclerosis

10

How can TO/Buerger's be diagnosed?

Clinically + exclude other causes.
-Hx and PEx
-ABI suggests ischaemia
-Echo excludes cardiac emboli
-Bloods exclude vasculitis, and antiphospholipid Ab syndrome
-angiography shows characteristic findings

11

Treatment of Buerger's

No specific treatment except abstention from tobacco