thromboangiitis

thromboangiitis obli´terans a disease affecting the medium-sized blood vessels, particularly the arteries of the lower limbs, which can cause severe pain and in serious cases lead to gangrene. The name refers to the clotting, pain, and inflammation occurring in this disease and to the fact that it can obliterate, or destroy, blood vessels. The cause has been thought to be excessive use of tobacco over a long period of time, and the number of cases has diminished strikingly in recent years. The intense pain is caused by thrombosis (formation of blood clots) in the lining of the arteries; when the clots grow larger, the blood flow slows and may stop entirely. Since every part of the body depends on the continuous flow of blood, affected areas such as fingers and toes, for example, soon begin to atrophy or develop ulcers. If the causes of the disease are not completely arrested, amputation may be necessary.



To treat the disease, the patient must stop smoking at once and entirely. This generally results in the partial healing of the affected membrane with a renewed flow of blood. However, more blood may have to be brought to damaged tissue by surgical methods of channeling detours or making canals in the clot itself. Sympathectomy may be tried to prevent any vasospastic component. Minor amputations of gangrenous tissue are often needed.

Special exercises called buerger-allen exercises are sometimes used to empty the engorged blood vessels and stimulate collateral circulation. These exercises can be done at home by patients and are usually prescribed to be done several times during the day. Patients are also instructed to avoid wearing any tight clothing, such as tight girdles, rolled garters, constricting belts, and other items that may impair circulation. They should also avoid sitting or standing in one position for long periods of time. Care should be used in the selection of shoes and stockings so that they fit properly and do not cause pressure against the blood vessels. Patients should be told to avoid walking barefoot or otherwise subjecting themselves to the hazards of trauma to the feet and legs. Should such an accident occur, no matter how minor it may seem, the patient must notify a health care provider so that treatment may be begun and infection and ulceration can be prevented.