[Buerger's disease: current concepts].
Buerger's disease or thromboangiitis obliterans is a non atherosclerotic, segmentar inflammatory vasculitis that reaches small and medium size vessels of the limbs's extremities. It affects predominantly young male smokers that present distal ischemia, clinically manifested through claudication, rest pain, ulcers and gangrene. A hundred years after its original description by Leo Buerger, the disease's etiology remains unclear, but it is acknowledged the importance of tobacco's role for the initiation, progression and prognosis of the pathology. Its incidence has globally declined, despite the relative increment of female cases owing to the crescent number of smoking women. The treatment has suffered a considerable evolution, manifested by the decreasing number of performed amputations, but it should always be followed by complete interruption of the smoking habits - the central attitude of the therapeutics. The introduction of the antagonists of cannabinoid like rimonabant, revealed promising in helping pacients stop smoking. Prostanoids are nowadays an important therapeutic attitude. Sympathectomy and omental transfer are included as surgical therapeutic options. The recent evolution in the discovery of new therapeutic resources in the angiogenesis scope, have opened up new possibilities for the treatment of Buerger's disease, considered one of the least treatable vasculitis.
Quintas
Anita
A
Serviço de Angiologia e Cirurgia Vascular do Hospital de S. João, Porto.
Albuquerque
Roncon
R
D006801:Humans; D013919:Thromboangiitis Obliterans / Q000175:diagnosis / Q000209:etiology / Q000628:therapy