Thromboangiitis Obliterans Definition, Reason, Symptoms, Treatment & Prevention
Definition
Thromboangiitis is also known as thromboangiitis obliterans or Buerger’s disease. This condition describes inflammation or inflammatory thrombosis of small and medium-sized arteries. In addition to some of the superficial veins, which causes ischemia in the distal extremities and thrombophlebitis (inflammation or inflammation of the veins) superficial.
In addition to the arteries and veins, thromboangiitis can also affect the innervation of the extremities. This disease has a high prevalence in Asia and the Middle East. In addition, this condition is mainly found in men aged 20–40 years.
Thromboangiitis Obliterans Symptom
Some of the symptoms that can be associated with thromboangiitis are:
- painful ulceration or gangrene of the finger
- hands and feet feel cold and slightly swollen
- pain at rest or inactivity
- intermittent claudication (pain caused by reduced blood flow), especially in the legs, thighs, arms, hands
- paresthesia (numbness, tingling, burning, lack of sensation, etc.)
- Superficial nodules or lumps follow the veins
Thromboangiitis Obliterans Reason
The exact cause of thromboangiitis obliterans is not known. However, it is known that tobacco use is a strong risk factor for the development of this disease. Almost all people with thromboangiitis are known to be smokers. However, thromboangiitis can also occur as a result of the habit of chewing tobacco or marijuana.
It is thought that the mechanism of thromboangiitis is related to delayed hypersensitivity reactions or toxic angiitis. In addition, it is also thought to be related to autoimmune reactions caused by cell-mediated sensitivity reactions to collagen types I and III. Collagen types I and III are the building blocks of blood vessels.
Diagnosis
To determine the diagnosis of thromboangiitis, the doctor will conduct a detailed medical interview to find out the patient’s medical history and the symptoms that are felt. In addition, a supporting physical examination and supporting examinations are also needed, especially to find blood vessel abnormalities through imaging.
The physical examination needed is an ankle-brachial index examination. This test compares the systolic blood pressure in the arm and ankle. This examination can help determine the presence of distal ischemia.
Investigations involving laboratory tests are often needed to help rule out other causes of the perceived complaint. Several types of tests that may be performed include a complete blood count, liver function examination, kidney function examination, urine analysis, fasting blood sugar, erythrocyte sedimentation rate (ESR), C reactive protein ( CRP), antinuclear antibody (ANA), rheumatoid factor (RF), antiphospholipid antibody, and so on.
Imaging examination in the form of angiography can help find the characteristics of thromboangiitis obliterans, namely occlusion or segmental blockage of the distal arteries (especially in the hands and feet). In the area around the blockage, curved blood vessels can be found and atherosclerosis is not found.
There are criteria that can be used to help establish the diagnosis of thromboangiitis, namely:
- age less than 45 years
- There is a history of tobacco use
- presence of distal limb ischemia
- absence of autoimmune disease, hypercoagulable state, or diabetes mellitus
- Absence of a proximal cause of atheroembolism
- There are consistent findings on arteriography
Thromboangiitis Obliterans Treatment
No form of therapy can definitively cure thromboangiitis. One of the most important steps that can be taken is to completely stop consuming tobacco (smoking). In addition, sufferers are also advised to avoid cold, drugs that cause vasoconstriction and avoid thermal, chemical and mechanical injuries.
Several types of drugs can be given. For example iloprost (prostaglandin analogue). The use of NSAIDs and analgesics can be given to help overcome complaints of pain. You can also consider doing lumbar sympathetic chemical ablation and surgical sympathectomy.