Buerger’s Disease

 

Buerger’s Disease

The another name for Buerger’s Disease is Thromboangiitis obliterans.

The blood vessels in the arms and legs are mostly affected in the body.

The swelling of blood vessels can prevent blood flow which may lead to clot formation.

This may result in pain,damage of tissue and also gangrene.

Symptoms of Buerger's disease:-

-The appearance of fingers or toes may be pale,red or bluish in colour

-Cold hands or feet

-Burning feet or tingling

-While walking legs,ankles or feet may be painful

-Small painful sores in the fingers or toes

Etiology

• Unknown cause

• Tobacco use play role in the development of Buerger's disease

Incidence:-

• Males of age (20-40yrs old )-heavy cigarette smokers are mostly affected with this disease.

• Females of age >50yrs cigarette smokers are affected with this disease.

Effect of smoking on Buerger's disease

-Use of tobacco is linked to the development of Buerger's disease.

-The chemicals present in tobacco irritates the lining of the blood vessels and causes them to swell

Classification:-

Type 1:- Upper limb TAO

Type 2:- involves legs and feet- crural/infrapopliteal

Type 3 :- Femoropopliteal

Type 4 :- Aortoiliofemoral

Type 5 :- Generalized

Investigations:-

• Blood sugar levels-Diabetes mellitus

• Lipid profile- any dyslipidemia

• Decreased Hb levels -delayed healing

• WBC count-infection

• Transfemoral retrograde angiogram

Diagnosis:-

-Arterial Doppler and duplex scan(Doppler+B mode U/S)

-DSA (Digital Subtraction Angiography)

Treatment:-

- Cessation of smoking

- Low dose aspirin 75mg OD -antithrombotic

- Prostacyclins, Ticlopidine, Praxylene, Carnitine - Antithrombotic effect

- Clopidogrel 75mg

- Atorvastatin in 10mg

- Cilostazole 100mg BD is a phosphodiesterase inhibitor which improves circulation

- All the drugs act on collateral level than at the diseased vessel

- Xanthine nicotinate 3000mg from 1to 9000mg on day 5 is given to promote ulcer healing and also increase claudication distance

- Analgesics are used to relieve the pain

References

1. National Heart, Lung, and Blood Institute. Types of vasculitis [accessed 2019 July 2].

2. Medline Plus. Thromboangiitis Obliteran [last updated 2019 June 3; accessed 2019 July 2].

3. Mayo Clinic . Buergers disease :Risk Factors[last updated 2019 Feb 1; accessed 2019 July 2].

4. Health and Medicine. Buerger’s disease[ 2017 August 13].

5. Education , Health and Medicine. Physiotherapy in Buerger’s disease [ 2011 July 7].

By Vadluri Prathyusha

CSRPL_INT_ONL_WKD_017/0121

Gmail id :- vadluriprathyusha1703@gmail.com