Difference between revisions of "Vascular disease"

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Vascular disease (view source)

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==Thromboangiitis obliterans==
==Thromboangiitis obliterans==
*[[AKA]] ''Buerger disease''.
{{Main|Thromboangiitis obliterans}}
**Should '''not''' be confused with ''Berger disease'' ([[IgA nephropathy]]).
 
===General===
*Strong association with smoking.<ref>{{Cite journal  | last1 = Highlander | first1 = P. | last2 = Southerland | first2 = CC. | last3 = VonHerbulis | first3 = E. | last4 = Gonzalez | first4 = A. | title = Buerger disease (thromboangiitis obliterans): a clinical diagnosis. | journal = Adv Skin Wound Care | volume = 24 | issue = 1 | pages = 15-7 | month = Jan | year = 2011 | doi = 10.1097/01.ASW.0000392923.37852.43 | PMID = 21173586 }}</ref>
*Clinical-radiologic diagnosis.<ref name=pmid20534945/>
 
Typical symptoms/signs - progression:<ref name=pmid22284771/>
*Intermittent claudication -> ulcers -> [[gangrene]] -> [[amputation]].
 
Treatment:
*Stop smoking.<ref name=pmid22284771>{{Cite journal  | last1 = Dargon | first1 = PT. | last2 = Landry | first2 = GJ. | title = Buerger's disease. | journal = Ann Vasc Surg | volume = 26 | issue = 6 | pages = 871-80 | month = Aug | year = 2012 | doi = 10.1016/j.avsg.2011.11.005 | PMID = 22284771 }}</ref>
 
===Gross===
*Afflicts small and medium-sized vessels of the extremities.
*Corkscrew vessels - seen on angiography.<ref name=pmid20534945>{{Cite journal  | last1 = Fujii | first1 = Y. | last2 = Soga | first2 = J. | last3 = Nakamura | first3 = S. | last4 = Hidaka | first4 = T. | last5 = Hata | first5 = T. | last6 = Idei | first6 = N. | last7 = Fujimura | first7 = N. | last8 = Nishioka | first8 = K. | last9 = Chayama | first9 = K. | title = Classification of corkscrew collaterals in thromboangiitis obliterans (Buerger's disease): relationship between corkscrew type and prevalence of ischemic ulcers. | journal = Circ J | volume = 74 | issue = 8 | pages = 1684-8 | month = Aug | year = 2010 | doi =  | PMID = 20534945 }}</ref>
 
===Microscopic===
Features:<ref name=pmid16892557>{{Cite journal  | last1 = Kurata | first1 = A. | last2 = Schulz | first2 = A. | last3 = Franke | first3 = FE. | title = Reappraisal of thromboangiitis obliterans--a pathological contribution. | journal = Verh Dtsch Ges Pathol | volume = 88 | issue =  | pages = 231-6 | month =  | year = 2004 | doi =  | PMID = 16892557 }}</ref>
*Acute inflammation:
** Endarteritis - neutrophils at the internal elastic lamina (IEL).
** Periarteritis - neutrophils around the arteries.
*Obliteration of the lumen - intimal thickening.
 
Notes:
* Typically segmental.<ref name=pmid22284771/>
 
DDx:
*[[Peripheral vascular disease]] ([[atherosclerosis]]) - typically lacks the acute inflammation around the IEL and around the vessels.
*[[Vasculitis]] - have [[fibrinoid necrosis]].
 
Images:
*[http://www.surgicalpathologyatlas.com/glfusion/mediagallery/media.php?f=0&sort=0&s=2008080217555643 Buerger's disease (surgicalpathologyatlas.com)].
 
===Sign out===
<pre>
MIDDLE FINGER DISTAL PHALYNX, LEFT, AMPUTATION:
- GANGRENE WITH ENDARTERITIS, PERIARTERITIS AND LUMINAL OBLITERATION/NARROWING
  CONSISTENT WITH THROMBOANGIITIS OBLITERANS (BUERGER'S DISEASE).
</pre>


==Thrombosis==
==Thrombosis==
Michael
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