Difference between revisions of "Thromboangiitis obliterans"

(Clinical Features)
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*In-step claudication
 
*In-step claudication
 
*Hand claudication
 
*Hand claudication
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*Raynaud phenomenon
 
**Often bilateral and symmetrical  
 
**Often bilateral and symmetrical  
 
**May lead to ulceration
 
**May lead to ulceration
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==References==
 
==References==
 
<references/>
 
<references/>
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==Video==
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{{#widget:YouTube|id=daB4UWA7RXk}}
  
 
[[Category:Vascular]]
 
[[Category:Vascular]]

Revision as of 20:12, 19 March 2019

Background

  • Also known as "Buerger's disease"
  • Idiopathic inflammatory occlusive disease of the hands and feet (exact pathogenesis unknown)

Risk factors

  • Tobacco use
    • Virtually all affected patients are smokers
  • Male
  • Middle Eastern

Clinical Features

Thromboangiitis obliterans of foot
PMC5024906 AJUM-14-18-g002.png
  • Red, tender nodules over peripheral arteries
    • May have diminished pulses
  • In-step claudication
  • Hand claudication
  • Raynaud phenomenon
    • Often bilateral and symmetrical
    • May lead to ulceration

Differential Diagnosis

Blue Digit

Evaluation

  • Clinical criteria for diagnosis (noninvasive testing not necessary)
    • History of smoking
    • Onset prior to <50 years old
    • Absence of atherosclerotic risk factors
    • Upper limb involvement
    • Infrapopliteal arterial occlusive lesions

Management

  • Abstinence from tobacco
  • Early symptoms with out threatened tissue loss: outpatient vascular
  • Advanced disease: intra-arterial or intravenous PGE1, ASA, Heparin, arterial reconstruction, sympathectomy

Disposition

  • Discharge with vascular follow-up if no evidence/threat of tissue loss
  • Otherwise admit

See Also

External Links

References


Video