Thromboangiitis obliterans

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Thromboangiitis obliterans, abbreviated TAO, is a rare vascular disease characterized by recurrent thrombosis. It primarily afflicts young smokers and is also known as Buerger disease.

It should not be confused with Berger disease (IgA nephropathy).

General

  • Strong association with smoking.[1]
  • Clinical-radiologic diagnosis.[2]

Typical symptoms/signs - progression:[3]

Treatment:

  • Stop smoking.[3]

Gross

  • Afflicts small and medium-sized vessels of the extremities.
  • Corkscrew vessels - seen on angiography.[2]

Microscopic

Features:[4]

  • Acute inflammation:
    • Endarteritis - neutrophils at the internal elastic lamina (IEL).
    • Periarteritis - neutrophils around the arteries.
  • Obliteration of the lumen - intimal thickening.

Notes:

  • Typically segmental.[3]

DDx:

Images:

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MIDDLE FINGER DISTAL PHALYNX, LEFT, AMPUTATION:
- GANGRENE WITH ENDARTERITIS, PERIARTERITIS AND LUMINAL OBLITERATION/NARROWING 
  CONSISTENT WITH THROMBOANGIITIS OBLITERANS (BUERGER'S DISEASE).

See also

References

  1. Highlander, P.; Southerland, CC.; VonHerbulis, E.; Gonzalez, A. (Jan 2011). "Buerger disease (thromboangiitis obliterans): a clinical diagnosis.". Adv Skin Wound Care 24 (1): 15-7. doi:10.1097/01.ASW.0000392923.37852.43. PMID 21173586.
  2. 2.0 2.1 Fujii, Y.; Soga, J.; Nakamura, S.; Hidaka, T.; Hata, T.; Idei, N.; Fujimura, N.; Nishioka, K. et al. (Aug 2010). "Classification of corkscrew collaterals in thromboangiitis obliterans (Buerger's disease): relationship between corkscrew type and prevalence of ischemic ulcers.". Circ J 74 (8): 1684-8. PMID 20534945.
  3. 3.0 3.1 3.2 Dargon, PT.; Landry, GJ. (Aug 2012). "Buerger's disease.". Ann Vasc Surg 26 (6): 871-80. doi:10.1016/j.avsg.2011.11.005. PMID 22284771.
  4. Kurata, A.; Schulz, A.; Franke, FE. (2004). "Reappraisal of thromboangiitis obliterans--a pathological contribution.". Verh Dtsch Ges Pathol 88: 231-6. PMID 16892557.