[Buerger's disease or thromboangiitis obliterans].
OBJECTIVE
To review clinical data, pathophysiology and treatment of thromboangiitis (Buerger's disease).


RESULTS
Buerger's disease or thromboangiitis obliterans (TAO) is an obliterative vascular disease that affects medium and small sized arteries as well as superficial veins. Young males and smokers are preferentially afflicted with the disease. TAO accounts for 0.5 to 5% of occlusive vascular disease. Though TAO has a world-wide distribution, it can be found with greater prevalence in Eastern Europe, the Mid-East, Asia, and Southeast Asia. Women account for 10 to 20% of the patients and 5 to 10% are more than 60-years-old. Approximately 95% are smokers and disease activity is strongly associated with the use of tobacco. The pathogenesis is poorly understood and most hypotheses are controversial. There is no specific marker of the disease and the diagnosis is based on clinical and angiographic criteria. The disease spontaneously leads to tissue loss and major amputations. This can generally be avoided by discontinuing smoking. Induced hypervolemia and prostacyclins are effective treatments of critical limb ischemia in TAO.


CONCLUSIONS
If pathophysiology is still poorly understood, spontaneous evolution can be avoided by stopping tobacco and prostacyclin.
Service de médecine interne, hôpital Saint-Antoine, Paris, France.
J L
JL
Reny
J
J
Cabane
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000671:Amputation, Surgical; D000792:Angiography; D002986:Clinical Trials as Topic; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D016285:Iloprost / Q000627:therapeutic use; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects; D016540:Smoking Cessation; D013562:Sympathectomy; D013919:Thromboangiitis Obliterans / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D014665:Vasodilator Agents / Q000627:therapeutic use
D014665:Vasodilator Agents; D016285:Iloprost
La maladie de Buerger ou thromboangéite oblitérante.