Details

Autor(en) / Beteiligte

• Olin, Jeffrey W
• Shih, Anthony

Titel

Thromboangiitis obliterans (Buergerʼs disease)

Ist Teil von

• Current opinion in rheumatology, 2006-01, Vol.18 (1), p.18-24

Ort / Verlag

United States: Lippincott Williams & Wilkins, Inc

Erscheinungsjahr

2006

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• PURPOSE OF REVIEWThromboangiitis obliterans is a nonatherosclerotic segmental inflammatory disease that affects the small and medium-sized arteries and veins in the upper and lower extremities. This review will help to familiarize physicians with this vasculitis that is completely different from every other type of vasculitis encountered. RECENT FINDINGSWhile tobacco is central to the initiation and continuance of Buergerʼs disease activity, two interesting pathophysiologic observations have been made. There is endothelial dysfunction in arteries not yet clinically or angiographically involved in thromboangiitis obliterans. There are elevated levels of antiendothelial cell antibodies and measurement of these antibody titers may be useful in following disease activity in Buergerʼs disease patients. The only therapy clearly shown to prevent amputation is the complete abstinence of tobacco. There is exciting work under way on the use of selective cannabinoid receptor antagonists to help patients stop smoking. In addition, preliminary results on use of therapeutic angiogenesis in patients with Buergerʼs disease has demonstrated excellent collateral blood vessels formation and clinical improvement. SUMMARYThe difficulty in studying rare diseases such as thromboangiitis obliterans is that there are no significant research dollars available and even the most active centers only see a few patients per year. Therefore, there has been little progress in understanding the pathogenesis of the disease. There are new therapeutic modalities that help patients with this disease, however, and patients can be assured that if they are able to discontinue tobacco use completely, amputation will not occur if critical limb ischemia is not already present.