it is known as burger's disease, Study notes of Physiotherapy

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TAO (thromboangina

obliterans)

By lakshmiprabha



Buerger's disease is a rare disease of the

arteries and veins in the arms and legs. In

Buerger's disease — also called

thromboangiitis obliterans -blood vessels

become inflamed, swell and can become

blocked with blood clots (thrombi).



This eventually damages or destroys skin

tissues and may lead to infection and

gangrene. Buerger's disease usually first

shows in hands and feet and may eventually

affect larger areas of arms and legs.

Definition.

 The disease is found worldwide, but the highest

incidence of thromboangiitis obliterans occurs in the

Middle and Far East.

 The prevalence of the disease in the general population

in Japan was estimated at 5/100,000 persons in 1985

[6].



The prevalence of the disease among all patients with

peripheral arterial disease ranges from values as low as

0.5 to 5.6% in Western Europe to values as high as 45

to 63% in India, 16 to 66% in Korea and Japan, and 80%

among Jews of Ashkenazi ancestry living in Israel. Part

of this variation in disease prevalence may be due to

variability in diagnostic criteria

Epidemiology

Tobaco users  periodontal disease  genetic predisposition  autoimmune response Causes.

 Fingers or toes that appear pale, red, or bluish and feel

cold to the touch.

 Sudden severe pain in the hands and feet. The pain may

feel like a burning or tingling.

 Pain in the hands and feet that most often occurs when at

rest. The pain may be worse when the hands and feet get

cold or during emotional stress.

 Pain in the legs, ankles, or feet when walking (intermittent

claudication). The pain is often located in the arch of the

foot.

 Skin changes or small painful ulcers on the fingers or toes.

 Occasionally, arthritis in the wrists or knees develops

before the blood vessels become blocked.

Symptoms.

 Ultrasound of the blood vessels in the extremity, called

plethysmography

 Doppler ultrasound of the extremity

 Catheter-based x-ray arteriogram

 Blood tests for other causes of inflamed blood vessels

(vasculitis) and blocked (occlusion of) blood vessels may be

done. These causes include diabetes, scleroderma,

vasculitis, hypercoagulability, and atherosclerosis. There

are no blood tests that diagnose thromboangiitis obliterans.

 A heart echocardiogram may be done to look for sources of

blood clots. In rare cases when the diagnosis is unclear, a

biopsy of the blood vessel is done.

Diagnosis

 (^) There is no cure for thromboangiitis obliterans. The goal of treatment is to control symptoms and prevent the disease from getting worse.  (^) Stopping tobacco use of any kind is key to controlling the disease. Smoking cessation treatments are strongly recommended. It is also important to avoid cold temperatures and other conditions that reduce blood flow in the hands and feet.  (^) Applying warmth and doing gentle exercises can help increase circulation.  (^) Aspirin and medicines that open the blood vessels (vasodilators) may help.  (^) surgery to cut the nerves to the area (surgical sympathectomy) can help control pain. Rarely, bypass surgery is considered in certain people.  (^) It may become necessary to amputate the fingers or toes if the area becomes very infected and tissue dies. Treatment