Buerger Disease Quiz and Flashcards: Thromboangiitis Obliterans Teste

Study Notes

A progressive, nonatherosclerotic, segmental, inflammatory disease affecting small and medium arteries of the upper and lower extremities
Typically affects people between 20 to 50 years old, with men being more frequently affected, especially smokers

Patients initially present with claudication in the foot, leg, arm, or hand, which may be mistaken for joint or neuromuscular problems
Progression of the disease leads to calf claudication, ischemic rest pain, and ulcerations on the toes, feet, or fingers (Raynaud phenomenon)
Migratory superficial phlebitis can be present in up to 16% of patients, indicating a systemic inflammatory response

Strict smoking cessation is key to treatment, with impressive disease remission in patients who abstain from smoking
Surgical intervention is minimal due to the lack of acceptable target vessels for bypass and limited autogenous vein conduits
Amputation avoidance is increased in patients who quit smoking
Morbidity is substantial, with 43% of patients requiring 1 or more amputations in 7.6 years if they continue to smoke

The prevalence of Buerger disease has decreased over the past 5 years due to decreased smoking and stricter diagnostic criteria
Highest incidence occurs in Israeli Jews of Ashkenazi descent and natives of Indian, Korean, and Japanese ancestry
Less frequent in subjects of northern European descent
Death from TAO is unusual, but morbidity is substantial

Thrombosis occurs in small to medium arteries and veins with associated dense polymorphonuclear leukocyte aggregation, microabscesses, and multinucleated giant cells
Chronic phase shows a decrease in hypercellularity and frequent recanalization of the vessel lumen
End-stage lesions demonstrate organized thrombus and blood vessel fibrosis
Patients with Buerger disease may have specific cellular immunity against arterial antigens, specific humoral anti-arterial antibodies, and elevated circulatory immune complexes

Pathologically, Buerger disease is manifested by the infiltration of round cells in all 3 layers of the arterial wall, unlike atherosclerosis which involves the intima and media
A precise diagnosis can be made only by tissue histology