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Disease Information : Buerger's Disease : Treatment

Buerger’s Disease : Treatment

What are the Treatment Options?

The most critical treatment for TAO is immediate and complete tobacco cessation (1). It is absolutely essential. The prognosis for patients with TAO depends completely upon whether they are able to quit smoking. Even a few cigarettes per day can worsen the disease. Mayo Clinic physicians have found that TAO patients who continue to smoke have a high rate of amputation that persists up to 17 years after first diagnosis. The risk of amputation in TAO patients who stop smoking is much lower. Patients should also avoid exposure to second-hand smoke. 

Medications such as iloprost may be helpful. Little is known about the best medical therapies for TAO, and more research is needed. To search for a clinical trial near you, go to www.clinicaltrials.gov. Surgery to restore blood flow is not usually possible because of the small size of the affected blood vessels.

What else should I know about TAO?

Unfortunately, knowledge about TAO is limited, and the long-term (greater than 15 year) risks of amputation and death are not well known. One widely-cited study of 112 patients was gathered from the Cleveland Clinic Foundation from 1970 to 1987 (2). The study revealed that skin ulcerations occurred among 76 percent of TAO patients. Additionally, 27 percent of TAO patients underwent one or more amputations (15 percent finger, 33 percent toe, 10 percent forefoot, 36 percent below the knee, 5 percent above the knee). Clots in the superficial veins of the arms and legs and Raynaud’s phenomenon (fingers turning white and painful upon cold exposure) are also common. Long-term survival in TAO patients is slightly lower than for the US population as a whole. The cause of this is not known but may be related to ongoing tobacco use (3)

 

(1) Piazza G, Creager MA.  Thromboangiitis obliterans.  Circulation. 2010;121:1858-1861

(2) J. Olin, J. Young, R. Graor, W. Ruschhaupt and J. Bartholomew, The changing clinical spectrum of thromboangiitis obliterans, Circulation 82 (Suppl IV) (1990), pp. IV3–8.

(3)Cooper LT, Tse TS, Mikhail MA, McBane RD, Stanson AW, Ballman KV. Long-term survival and amputation risk in Thromboangiitis obliterans (Buerger's disease). J Am Coll Cardiol 2004 Dec 21; 44(12):2410-1

 


Buerger’s Disease section was last modified: December 21, 2010 - 05:08 pm

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