[Evaluation of hemodynamic changes in Buerger's disease patients].
BACKGROUND
Buerger's disease or thromboangiitis obliterans (TAO) is a vascular disease characterized by vascular and segmental occlusion of small and medium-sized arteries of the extremities, caused by an inflammatory and thrombotic phenomena. The aim of this study was to evaluate functionally the hemodynamic consequences of this disease and its main arterial vascular changes.


METHODS
A retrospective clinical study was conducted with a sample of 100 patients diagnosed with TAO, who underwent to follow-up appointments every two years for peripheral arterial doppler, plethysmography and ankle-brachial index (ABI) at the Department of Angiology and Vascular Surgery of the Hospital de São João in Porto. To conduct the study, the last hemodynamic evaluation of each patient was selected between 2004 and 2010.


RESULTS
It was observed that tobacco has an unquestionable role in TAO, both in the rate of limb amputations (p = 0.006) and ABI values, with significant differences between non-smokers and groups of former and current smokers. Monophasic flow patterns are associated with low resistance spectrum and lower ABI values when compared to biphasic and triphasic flow patterns (p < 0.001). Normal ABI have a lower prevalence of collateral arteries associated in the right (p = 0.005) and left limbs (p = 0.032).


CONCLUSIONS
The clinical manifestations of peripheral vascular disease characteristic of TAO were reflected hemodynamically with monophasic low-resistance patterns associated with altered ABI values. Tobacco has an important role in the vascular blood flow, determinating high rates of amputation and low ABI values.
Escola Superior de Saúde Dr. Lopes Dias, Castelo Branco, Portugal.
Inês
I
Vicente
Ana
A
Alves
Alexandre
A
Pereira
Roberto
R
Roncon de Albuquerque
D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013919:Thromboangiitis Obliterans / Q000503:physiopathology*