Thromboangiitis Obliterans

  • Otacílio de Camargo JúniorEmail author
  • Juliana Lech de Camargo


Thromboangiitis obliterans (TAO) was reported in the literature for the first time in 1879 by Felix von Winiwarter [59], who described a vascular syndrome that progressed to gangrene of the lower limb with extensive thrombosis of the arteries and small veins, with preservation of the internal elastic membrane. These pathological findings were in a male patient, 57 years old, presenting with foot pain that had begun 12 years ago, turned into gangrene, and resulted in amputation. Intimal proliferation with thrombosis, fibrosis, and endarteritis different from arteriosclerosis were demonstrated in a pathological specimen.


Giant Cell Arteritis Mixed Connective Tissue Disease Internal Elastic Lamina Major Amputation Superficial Thrombophlebitis 
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  1. 1.
    Adar R, Papa MZ, Halpern Z, et al. Cellular sensitivity to collagen in thromboangiites obliterans. N Engl J Med. 1983;308:1113–6.PubMedCrossRefGoogle Scholar
  2. 2.
    Albuquerque RR, Delgado ML, Correia P, et al. Circulating immune complexes in Buerger’s disease. J Cardiovasc Surg. 1989;30:821–3.Google Scholar
  3. 3.
    Allegra C. Therapeutique de la maladie de Buerger. J Mal Vasc. 1989;14:45–6.PubMedGoogle Scholar
  4. 4.
    Alpaslan M, Akgun G, Doven O, Oral D. Thrombus in the main pulmonar artery of a patient with thromboangiitis obliterans: observation by transthoracic echocardiography. Eur J Echocardiogr. 2001;2:139–40.PubMedCrossRefGoogle Scholar
  5. 5.
    Avcu F, Akar E, Demirkiliç U, et al. The role of prothrombotic mutations in patients with Buerger’s disease. Thromb Res. 2000;100:143.PubMedCrossRefGoogle Scholar
  6. 6.
    Bollinger A, Piquerez MJ, Largiarder J, Scneider E. Maladie de Buerger: concepts diagnostiques et therapeutiques actueels. Ann Med Interne. 1983;134:436–40.Google Scholar
  7. 7.
    Cakmak A, Gyedu A, Akyol C, et al. Occlusion of the celiac trunk, the inferior mesenteric artery and stenosis of the superior mesenteric artery in peripheral thromboangiitis obliterans. Vasa. 2009;38:394.PubMedCrossRefGoogle Scholar
  8. 8.
    Caramaschi P, Biasi D, Carletto A, et al. Three cases of Buerger’s disease associated with hyperhomocysteinemia. Clin Exp Rheumatol. 2000;18:264–5.PubMedGoogle Scholar
  9. 9.
    Chen YW, Nagasawa T, Wara-Aswapati N, et al. Association between periodontitis and anti-cardiolipin antibodies in Buerger disease. J Clin Periodontol. 2009;36:83.CrossRefGoogle Scholar
  10. 10.
    Chierichetti F, Mambrini S, Bagliani A, Odero A. Treatment of Buerger’s disease with electrical spinal cord simulations: review of three cases. Angiology. 2002;53:341–7.PubMedCrossRefGoogle Scholar
  11. 11.
    Cooper LT, Tse TS, Mikhail MA, et al. Long-term survival and amputation risk in thromboangiitis obliterans (Buerger’s disease). J Am Coll Cardiol. 2004;44:2410.PubMedCrossRefGoogle Scholar
  12. 12.
    Corelli F. Buerger’s disease: cigarette smoker disease may always be cured by medical therapy alone: uselessness of operative treatment. J Cardiovasc Surg (Torino). 1973;14:28–36.Google Scholar
  13. 13.
    Cupps TR, Fauci AS. The vasculitides. In: Lloyd H, Smith Jr MD, editors. Major problems in internal medicine, vol. XXI. Philadelphia: Saunders; 1981. p. 133–41.Google Scholar
  14. 14.
    Dean SM, Satiani B. Three cases of digital ischemia successfully treated with cilostazol. Vasc Med. 2001;6:245–8.PubMedCrossRefGoogle Scholar
  15. 15.
    Dean SM, Vaccaro PS. Successful pharmacologic treatment of lower extremity ulcerations in 5 patients with chronic critical limb ischemia. J Am Board Fam Pract. 2002;15:55–62.PubMedGoogle Scholar
  16. 16.
    De Giacomo T, Rendina EA, Venuta F, et al. Thoracoscopic sympathectomy for symptomatic arterial obstruction of the upper extremities. Ann Thorac Surg. 2002;74:885–8.PubMedCrossRefGoogle Scholar
  17. 17.
    Dible JH. The pathology of limb ischemia. Edinburgh: Oliver & Boyd; 1966.Google Scholar
  18. 18.
    Dilege S, Aksoy M, Kayabali M, et al. Vascular reconstruction in Buerger’s disease: is it feasible? Surg Today. 2002;32:1042–7.PubMedCrossRefGoogle Scholar
  19. 19.
    Disdier P, Granel B, Serratrice J, et al. Cannabis arteritis revisited: ten new case reports. Angiology. 2001;52:1–5.PubMedGoogle Scholar
  20. 20.
    Donatelli F, Triggiani M, Nascimbene S, et al. Thromboangiitis obliterans of coronary and internal thoracic arteries in a young woman. J Thorac Cardiovasc Surg. 1997;113:800.PubMedCrossRefGoogle Scholar
  21. 21.
    Ehrenfeld M, Adar R. Rheumatic manifestations in patients with thromboangiitis obliterans (Buerger’s disease). J Rheumatol. 2000;27:1818–9.PubMedGoogle Scholar
  22. 22.
    Eichhorn J, Sima D, Lindschau C, et al. Antiendothelial cell antibodies in thromboangiitis obliterans. Am J Med Sci. 1998;315:17.PubMedCrossRefGoogle Scholar
  23. 23.
    Grove WJ, Stansby GP. Buerger’s disease and cigarette smoking in Bangladesh. Ann R Coll Surg Engl. 1992;74:115.PubMedGoogle Scholar
  24. 24.
    Gulati SM, Madhra K, Thusoo TK, Nair SK, Saha K. Autoantibodies in thromboangiitis obliterans (Buerger’s diseas). Angiology. 1982;33:642–51.PubMedCrossRefGoogle Scholar
  25. 25.
    Gulati SM, Saha K, Argawal V, Thusoo TK, Mehdiratta KS. Profile of non-organ specific autoantibodies in thromboangiitis obliterans. Indian J Med Res. 1984;80:228–31.PubMedGoogle Scholar
  26. 26.
    Gulati SM, Saha K, Kant L, Thusoo TK, Prakash A. Significance of circulatory immune complexes in thromboangiitis obliterans (Buerger’s disease). Angiology. 1984;35:276–81.PubMedCrossRefGoogle Scholar
  27. 27.
    Harten P, Muller-Huelsbeck S, Regensburger D, Loeffler H. Multiple organ manifestations in thromboangiitis obliterans (Buerger’s disease): a case report. Angiology. 1996;47:419–25.PubMedCrossRefGoogle Scholar
  28. 28.
    Inada K, Iwashima Y, Okada A, Matsumoto K. Nonatherosclerotic segmental arterial occlusion of the extremity. Arch Surg. 1974;108:663–7.PubMedCrossRefGoogle Scholar
  29. 29.
    Inan M, Alat I, Kutlu R, et al. Successful treatment of Buerger’s disease with intramedullary K-wire: the results of the first 11 extremities. Eur J Vasc Endovasc Surg. 2005;29:277.PubMedCrossRefGoogle Scholar
  30. 30.
    Iwai T, Inoue Y, Umeda M, et al. Oral bacteria in the occluded arteries of patients with Buerger disease. J Vasc Surg. 2005;42:107.PubMedCrossRefGoogle Scholar
  31. 31.
    Joras M, Poredos P, Fras Z. Endothelial dysfunction in Buerger’s disease and its relation to markers of inflammation. Eur J Clin Invest. 2006;36:376.PubMedCrossRefGoogle Scholar
  32. 32.
    Joyce JW. Buerger’s disease (thromboangiitis obliterans. Rheum Dis Clin North Am. 1990;16:463–70.PubMedGoogle Scholar
  33. 33.
    Kauffman P. Simpatectomias. In: Raia AA, Zerbini EJ, editors. Clinica Cirurgica Alipio Correa Netto, vol. 2o. 4a ed. Sao Paulo: Sarvier; 1998. p. 84–101.Google Scholar
  34. 34.
    Kobayashi M, Ito M, Nakagawa A, et al. Immunohistochemical analysis of arterial wall cellular infiltration in Bueger’s disease (endarteritis obliterans). J Vasc Surg. 1999;29:451–8.PubMedCrossRefGoogle Scholar
  35. 35.
    Krasznai A, Krajesi P, Aranyi P, Horvath I. Glucocorticoid receptors in thromboangiitis obliterans. Int J Clin Pharmacol Ther Toxicol. 1987;25:363–5.PubMedGoogle Scholar
  36. 36.
    Kurata A, Nonaka T, Arimura Y, et al. Multiple ulcers with perforation of the small intestine in Buerger’s disease: a case report. Gastroenterology. 2003;125:911.PubMedCrossRefGoogle Scholar
  37. 37.
    Laohapensang K, Rerkasem K, Kattipattanapong V. Seasonal variation of Buerger’s disease in Northern part of Thailand. Eur J Vasc Endovasc Surg. 2004;28:418.PubMedCrossRefGoogle Scholar
  38. 38.
    Leu HJ, Bollinger A. Phlebitis saltans sive migrans. Vasa. 1978;7:440–2.PubMedGoogle Scholar
  39. 39.
    Leu HJ. Early inflammatory changes in thromboangiitis obliterans. Pathol Microbiol (Basel). 1975;432:151–6.Google Scholar
  40. 40.
    Lie JT. Buerger’s disease and inflammatory aspects of atherosclerosis. Curr Opin Rheumatol. 1990;2:76–80.PubMedCrossRefGoogle Scholar
  41. 41.
    Lie JT. Diagnostic histopathology of major systemic and pulmonar vasculitis syndromes. Rheum Dis Clin North Am. 1990;16:269–92.PubMedGoogle Scholar
  42. 42.
    Lie JT. The rise and fall and resurgence of thromboangiitis obliterans (Buerger’s disease). Acta Pathol Jpn. 1989;39:153.PubMedGoogle Scholar
  43. 43.
    Lie JT. Thromboangiitis obliterans (Buerger’s disease) and smokeless tobacco. Arthritis Rheum. 1988;316:812–3.CrossRefGoogle Scholar
  44. 44.
    Lie JT, Michet Jr CJ. Thromboangiitis obliterans with eosinophilia (Buerger’s disease) of the temporal arteries. Hum Pathol. 1988;19:598–602.PubMedCrossRefGoogle Scholar
  45. 45.
    Makita S, Nakamura M, Murakami H, et al. Impaired endothelium-dependent vasorelaxation in peripheral vasculature of patients with thromboangiitis obliterans (Buerger’s disease). Circulation. 1996;94(Suppl):II211–5.PubMedGoogle Scholar
  46. 46.
    Maslowski L, McBane R, Alexewicz P, Wysokinski WE. Antiphospholipid antibodies in thromboangiitis obliterans. Vasc Med. 2002;7:259–64.PubMedCrossRefGoogle Scholar
  47. 47.
    Matsushita M, Shionoya S, Matsumoto T. Urinary cotinine measurement in patients with Buerger’s disease – effects of active and passive smoking on the disease process. J Vasc Surg. 1991;14:53–8.PubMedCrossRefGoogle Scholar
  48. 48.
    Melian EB, Goa KL. Beraprost: a review of its pharmacology and therapeutic efficacy in the treatment of peripheral arterial disease and pulmonar arterial hypertension. Drugs. 2002;62:107–33.PubMedCrossRefGoogle Scholar
  49. 49.
    Michail PO, Filis KA, Delladetsima JK, et al. Thromboangiitis obliterans (Buerger’s disease) in visceral vessels confirmed by angiographic and histological findings. Eur J Vasc Endovasc Surg. 1998;16:445.PubMedCrossRefGoogle Scholar
  50. 50.
    Mills JL, Porter JM. Buerger’s disease: a review and update. Semin Vasc Surg. 1993;6:14–23.PubMedGoogle Scholar
  51. 51.
    Mills JL, Porter JM. Buerger’s disease (thromboangiitis obliterans). Ann Vasc Surg. 1991;5:570–2.PubMedCrossRefGoogle Scholar
  52. 52.
    Muraco Neto B. Neurotripsia. Tratamento da dor isquêmica de repouso nas extremidades inferiores. In: Raia AA, Zerbini EJ, editors. Clinica Cirurgica Alipio Correa Netto, vol. 2o. 4a ed. Sao Paulo: Sarvier; 1998. p. 102–6.Google Scholar
  53. 53.
    Nishikimi N. Fate of limbs with failed vascular reconstruction in Buerger’s disease patients. Int J Cardiol. 2000;75(Suppl I):S183–5.PubMedCrossRefGoogle Scholar
  54. 54.
    Nishikimi N, Shionoya S, Mizuno S. Result of national epidemiological study of Buerger’s disease. J Jpn Coll Angiol. 1987;27:1125–30.Google Scholar
  55. 55.
    Noel B. Cocaine and arsenic induced Raynaud’s phenomenon. Clin Rheumatol. 2002;21:343–4.PubMedCrossRefGoogle Scholar
  56. 56.
    Ohta T, Ishioashi H, Hosaka M, Sugimoto I. Clinical and social consequences of Buerger disease. J Vasc Surg. 2004;39:176.PubMedCrossRefGoogle Scholar
  57. 57.
    Olin JW. Are anticardiolipin antibodies really importante in thromboangiitis obliterans (Bueger’s disease)? Vasc Med. 2002;7:257–8.PubMedCrossRefGoogle Scholar
  58. 58.
    Olin JW. Thromboangiitis obliterans (Buerger’s disease). N Engl J Med. 2000;343:864–9.PubMedCrossRefGoogle Scholar
  59. 59.
    Olin JW. Thromboangiitis obliterans (Buerger’s disease). In: Rhutherford RB, editor. Vascular surgery. 6th ed. New York: Elsevier Inc; 2007. p. 404–16.Google Scholar
  60. 60.
    Olin JW, Childs MB, Bartholomew JR, et al. Anticardiolipin antibodies and homocysteine levels in patients with thromboangiitis obliterans. Arthritis Rheum. 1996;39:S-47.Google Scholar
  61. 61.
    Olin JW, Shih A. Thromboangiitis obliterans (Buerger’s disease). Curr Opin Rheumatol. 2006;18:18–24.PubMedCrossRefGoogle Scholar
  62. 62.
    Olin JW, Young JR, Graor RA, et al. The changing clinical spectrum of thromboangiitis obliterans (Buerger’s disease). Circulation. 1990;825(Suppl):IV3–8.Google Scholar
  63. 63.
    Pace AV, Saratzis N, Karokis D, et al. Spinal cord simulation in Buerger’s disease. Ann Rheum Dis. 2002;61:1114.PubMedCrossRefGoogle Scholar
  64. 64.
    Papa MZ, Adar R. A critical look at thromboangiitis obliterans (Buerger’s disease). Vasc Surg. 1992;5:1–21.Google Scholar
  65. 65.
    Pietraszek MH, Choudhury NA, Koyano K, et al. Enhanced platelet response to serotonina in Buerger’s disease. Thromb Res. 1990;60:241–6.PubMedCrossRefGoogle Scholar
  66. 66.
    Puchmayer V. Smoking as a risk for the development of arterial occlusive disease. Acta Univ Carol Med Monogr (Praha). 1984;105:1.Google Scholar
  67. 67.
    Puechal X, Fiessinger JN, Kahan A, Menkes CJ. Rheumatic manifestations in patients with thromboangiitis obliterans (Buerger’s disease). J Rheumatol. 1999;26:1764–8.PubMedGoogle Scholar
  68. 68.
    Roncon-de-Albuquerque R, Delgado L, Correia P, et al. Circulating imune complexes in Buerger’s disease: endarteritis obliterans in young men. J Cardiovasc Surg (Torino). 1989;30:821–5.Google Scholar
  69. 69.
    Scarffetter K, Blasius S, Franke RP, Kohler M, Mittermayer C. Pathogenetic key position of thromboangiitis: the endotelial cell. Serum dependente proliferation studies of endotelial cells in obliteratives angiopathies. Vasa. 1986;15:34–7.Google Scholar
  70. 70.
    Stammler F, Diehm C, Hsu E, Stockinger K, Amendt K. Pravalenz der Hyperhomocysteinamic bei der Thromboangiitis obliterans. Spielt Homocystein pathogenetisch eine Rolle? Dtsch Med Wochenschr. 1996;121:1417–23.PubMedCrossRefGoogle Scholar
  71. 71.
    Shionoya S. Buerger’s disease (thromboangiitis obliterans). In: Rutherford RB, editor. Vascular surgery. 3rd ed. Philadelphia: WB Saunders; 1989. p. 207–17.Google Scholar
  72. 72.
    Shionoya S, Ban I, Nakata Y, et al. Involvement of the iliac artery in-Buerger’s disease (pathogenesis and arterial reconstruction). J Cardiovasc Surg (Torino). 1978;19:69–76.Google Scholar
  73. 73.
    Swigris JJ, Olin JW, Mekhail NA. Implantable spinal cord stimulator to treat the ischemic manifestations of thromboangiitis obliterans (Buerger’s disease). J Vasc Surg. 1999;29:928–35.PubMedCrossRefGoogle Scholar
  74. 74.
    Taguchi A, Ohtani M, Soma T, et al. Therapeutic angiogenesis by autologous bone-marrow transplantation in a general hospital setting. Eur J Vasc Endovasc Surg. 2003;25:276–8.PubMedCrossRefGoogle Scholar
  75. 75.
    Tarygin NE, Shilkina NP, Romanov VA, Lileeva MA. The morphological criteria of thromboangiitis and arteriosclerosis obliterans of the vessels of the lower extremities. Ter Arkh. 1990;62:122–6.Google Scholar
  76. 76.
    Watarida S, Shiraishi S, Fujimura M, et al. Laparoscopic lumbar sympathectomy for lower-limb disease. Surg Endosc. 2002;16:500–3.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London 2013

Authors and Affiliations

  • Otacílio de Camargo Júnior
    • 1
    • 2
    Email author
  • Juliana Lech de Camargo
    • 3
  1. 1.Department of Vascular/Endovascular SurgeryPontifical Catholic University of Campinas, Celso Pierro Maternity HospitalSao PauloBrazil
  2. 2.Department of Vascular SurgeryPontifical Catholic University of CampinasSao PauloBrazil
  3. 3.Department of MedicineUniversity of TaubateSão PauloBrazil

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