medigraphic.com
ISSN 2500-7106 (Electronic)
ISSN 0123-2576 (Print)
Medicina & Laboratorio

2023, Number 3

<< Back Next >>

Medicina & Laboratorio 2023; 27 (3)

Buerger's disease or the endothelium as a labyrinth: case report

Rondón-Carvajal J, Guzmán-Arango D, Cano-Márquez D

Language: Spanish
References: 17
Page: 211-221
PDF size: 317.03 Kb.


ABSTRACT

Buerger's disease, also called thromboangiitis obliterans, is a non-atherosclerotic, segmental, transmural inflammatory vascular disease affecting small and medium-sized vessels of the extremities with a special etiopathogenic association with smoking; it commonly occurs in men under 50 years of age, and is a differential diagnosis in the setting of patients with chronic ischemia. We describe the case of a 43-year-old man, with a history of heavy smoking, who presented with intermittent claudication reaching pain at rest, associated with ulcers of vasculopathic appearance in the lower limbs, in the absence of distal pulses (pedius, posterior tibial); plethysmography reported greater infrapopliteal involvement, with segmental collateral circulation by arteriography, without the possibility of endovascular revascularization. The case was considered compatible with Buerger's disease, and hybrid management was weighed: medical (with antiplatelet agents) and surgical (with direct femoropopliteal bridging). A brief review of this rare disease is presented.


REFERENCES

  1. Fazeli B, Rezaee SA. A review on thromboangiitisobliterans pathophysiology: thrombosisand angiitis, which is to blame? Vascular 2011;19:141-153. https://doi.org/10.1258/vasc.2010.ra0045.

  2. Qaja E, Muco E, Hashmi MF. Buerger disease.Treasure Island (FL): StatPearls Publishing;2023. Acceso 10 de febrero de 2023. Disponibleen https://www.ncbi.nlm.nih.gov/books/NBK430858/.

  3. Klein-Weigel PF, Richter JG. Thromboangiitisobliterans (Buerger's disease).Vasa 2014;43:337-346. https://doi.org/10.1024/0301-1526/a000371.

  4. Muñoz-Vahos CH, Herrera-Uribe S, Arbeláez-Cortés Á, Jaramillo-Arroyave D, González-Naranjo LA, Vásquez-Duque G, et al. Clinicalprofile of levamisole-adulterated cocaine-inducedvasculitis/vasculopathy: A 30-case series. JClin Rheumatol 2019;25:e16-e26. https://doi.org/10.1097/rhu.0000000000000813.

  5. Arkkila PE. Thromboangiitis obliterans(Buerger's disease). Orphanet J Rare Dis2006;1:14. https://doi.org/10.1186/1750-1172-1-14.

  6. Rivera-Chavarría IJ, Brenes-Gutiérrez JD.Thromboangiitis obliterans (Buerger's disease).Ann Med Surg (Lond) 2016;7:79-82. https://doi.org/10.1016/j.amsu.2016.03.028.

  7. Gallagher KA, Tracci MC, Scovell SD. Vasculararteritides in women. J Vasc Surg 2013;57:27s-36s. https://doi.org/10.1016/j.jvs.2012.10.119.

  8. Fazeli B, Ligi D, Keramat S, Maniscalco R,Sharebiani H, Mannello F. Recent updatesand advances in Winiwarter-Buerger disease(thromboangiitis obliterans): Biomolecular mechanisms,diagnostics and clinical consequences.Diagnostics (Basel) 2021;11:1736. https://doi.org/10.3390/diagnostics11101736.

  9. Jaff MR. Thromboangiitis obliterans(Buerger's disease). Curr Treat Options CardiovascMed 2000;2:205-212. https://doi.org/10.1007/s11936-000-0014-1.

  10. Piazza G, Creager MA. Thromboangiitis obliterans.Circulation 2010;121:1858-1861. https://doi.org/10.1161/circulationaha.110.942383.

  11. Klein-Weigel P, Volz TS, Zange L, Richter J.Buerger's disease: providing integrated care.J Multidiscip Healthc 2016;9:511-518. https://doi.org/10.2147/jmdh.S109985.

  12. Jorge VC, Araújo AC, Noronha C, PanarraA, Riso N, Vaz Riscado M. Buerger's disease(Thromboangiitis obliterans): a diagnostic challenge.BMJ Case Rep 2011;2011:bcr0820114621.https://doi.org/10.1136/bcr.08.2011.4621.

  13. Lazarides MK, Georgiadis GS, Papas TT,Nikolopoulos ES. Diagnostic criteria andtreatment of Buerger's disease: a review. Int JLow Extrem Wounds 2006;5:89-95. https://doi.org/10.1177/1534734606288817.

  14. Fazeli B, Dadgar Moghadam M, NiroumandS. How to treat a patient with thromboangiitisobliterans: A systematic review. Ann Vasc Surg2018;49:219-228. https://doi.org/10.1016/j.avsg.2017.10.022.

  15. Fiessinger JN, Schäfer M. Trial of iloprost versusaspirin treatment for critical limb ischaemiaof thromboangiitis obliterans. The TAOStudy. Lancet 1990;335:555-557. https://doi.org/10.1016/0140-6736(90)90346-7.

  16. Cacione DG, Macedo CR, Baptista-SilvaJC. Pharmacological treatment forBuerger's disease. Cochrane DatabaseSyst Rev 2016;3:Cd011033. https://doi.org/10.1002/14651858.CD011033.pub3.

  17. Cacione DG, do Carmo-Novaes F, MorenoDH. Stem cell therapy for treatment of thromboangiitisobliterans (Buerger's disease). CochraneDatabase Syst Rev 2018;10:Cd012794.https://doi.org/10.1002/14651858.CD012794.pub2.




2020     |     www.medigraphic.com