Buerger's disease: providing integrated care.

Area of Science:

• Vascular Medicine
• Immunopathology

Background:

• Buerger's disease, or thromboangiitis obliterans (TAO), is a segmental inflammatory condition affecting small- to medium-sized vessels.
• It is strongly associated with tobacco use, with emerging evidence suggesting an immunopathogenesis.

Approach:

• Diagnosis relies on clinical and angiomorphologic criteria, excluding other risk factors for vascular disease.
• Current therapeutic interventions focus on smoking cessation and intravenous prostanoid infusions (iloprost).
• Pain management, including spinal cord stimulation, and wound/infection prevention are crucial for limb salvage.

Key Points:

• Revascularization is limited due to distal arterial occlusions.
• Novel treatments include immunoadsorption, cell-based therapies, and bosentan.
• Integrated care involving multidisciplinary teams is essential for optimal outcomes.

Conclusions:

• There is no definitive causative therapy for TAO.
• Comprehensive management strategies are vital for preventing amputations and improving patient prognosis.