Clinical Management of Thromboangiitis Obliterans
Summary
Thromboangiitis obliterans is a non‐atherosclerotic, segmental inflammatory vasculopathy principally affecting small and medium arteries and veins of the extremities in young smokers. Complete tobacco cessation is universally recognised as the only intervention that halts disease progression. Initial management centres on smoking abstinence and optimisation of cardiovascular risk factors. Pharmacological measures—such as antiplatelet agents, vasodilators (for example prostacyclin analogues, calcium-channel blockers) and agents that improve microcirculatory flow—aim to relieve ischaemic pain but do not uniformly prevent limb loss. Surgical options include distal revascularisation, lumbar sympathectomy and novel techniques such as omentopexy or Ilizarov bone distraction, which may promote collateral formation. Endovascular approaches have emerged to re-establish patency in critical limb ischaemia, while neuromodulation via spinal cord stimulation represents an adjunct for refractory rest pain. Experimental therapies are exploring angiogenic cytokines, endothelin receptor antagonists and autologous stem cell implantation to enhance neovascularisation and tissue repair. Multidisciplinary care with vascular medicine, interventional radiology and rehabilitation services is essential to preserve limb function and optimise quality of life.
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Clinical Management of Thromboangiitis Obliterans publication trend
The graph below shows the total number of articles in clinical management of thromboangiitis obliterans across all publications each year (not limited to Nature Index journals).
Technical terms
Thromboangiitis obliterans: A segmental inflammatory occlusive disease of small and medium vessels linked to tobacco exposure.
Excimer laser–assisted angioplasty: A technique combining ultraviolet laser ablation with balloon dilation to clear thrombotic occlusions.
Ankle–brachial index (ABI): A noninvasive ratio of ankle to arm systolic pressure used to assess peripheral perfusion.
Biomarker: A molecular indicator measured in blood or tissue that reflects pathophysiological processes or therapeutic response.
Oxidative stress: An imbalance between reactive oxygen species production and antioxidant defenses leading to cellular damage.
References
- Thromboangiitis obliterans (Buerger's disease). Orphanet Journal of Rare Diseases (2006).
- Thromboangiitis Obliterans (Buerger’s Disease)—Current Practices. International Journal of Inflammation (2013).
- Endovascular Excimer Laser-Assisted Balloon Angioplasty for Infrapopliteal Arteries in Thromboangiitis Obliterans: A Treatment for Acute-Phase TAO. Frontiers in Cardiovascular Medicine (2022).
- Recent Updates and Advances in Winiwarter-Buerger Disease (Thromboangiitis Obliterans): Biomolecular Mechanisms, Diagnostics and Clinical Consequences. Diagnostics (2021).
- The Imbalance among Oxidative Biomarkers and Antioxidant Defense Systems in Thromboangiitis Obliterans (Winiwarter-Buerger Disease). Journal of Clinical Medicine (2020).
- Circulating Angiogenic Factors in Patients with Thromboangiitis Obliterans. PLOS ONE (2012).
- Treatment of thromboangiitis obliterans (Buerger's disease) with bosentan. BMC Cardiovascular Disorders (2012).
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