Flashcards in Buerger's Disease / Thromboangitis obliterans Deck (11):
What is thromoboangitis obliterates?
Inflammatory occlusive thrombosis of small and medium sized arteries and some superficial veins usually in the distal and upper extremities
Who is affected by TO?
-Occurs almost exclusively in tobacco users
-Usu males 20-40y
-Asia, Far East, Middle East
Which genotypes are associated with TO?
What occurs in acute thromboangitis obliterates?
-occlusive thrombi accompany neutrophilic and lymphocytic infiltration of intima
-endothelial cells proliferate
-internal elastic lamina remains intact
What occurs in intermediate TO?
Thrombi organise and reconciles incompletely.
-media preserved but may be infiltrated by FBs
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)
What are the CFx of TO?
-claudication of affected extremity (+/- trophic / ischaemic changes)
-migratory superficial thrombophlebitis
Where does claudication occur in TO and why?
-Lower calves and feet
-forearms and hands
TO affects distal vessels
What is demonstrated on angiography in TO?
-segmental occlusion of distal arteries of hands and feet
-torturous, corkscrew collateral vessels around occlusions
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