Thromboangitis Obliterans

​Vasculitis is an inflammation of the blood vessel wall.

​Classification

• Large vessel vasculitis: involves the aorta and it’s major branches; e.g. giant cell arteritis, and Takayasu arteritis
• Medium vessel vasculitis: involves muscular arteries; e.g. polyarteritis nodosa, Kawasaki disease, and thromboangitis obliterans.
• Small vessel vasculitis: involves arterioles and capillaries; e.g. Granulomatosis with polyangitis (formerly known as Wegner’s granulomatosis), microscopic polyangitis, Churg-Strauss syndrome.

Thromboangitis obliterans

• Pathogenesis: it is an inflammatory endarteritis that causes vaso-occlusive phenomenon. It involves small and medium-sized arteries and is limited to tunica intima. Legs are always involved. It is associated with smoking.
• Clinical Presentation: it is more common in young males in Jews, Indians and Koreans. Claudication is the first manifestation. Complications like ulcers, gangrene and auto-amputation of fingers and toes can develop if blood flow is severely compromised. It can involve neural components and vein (phlebitis)
• Diagnosis: clinical
• Management: smoking cessation is best first and last step in management. Prostaglandins, alpha blockers, nifedipine, or pentoxyfilline can be considered but. pharmacological therapy is generally ineffective and endovascular revascularization is not possible.

Next: Wegner's Granulomatosis
Previous: Kawasaki Disease

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​Adapted from: Fundamentals of Cardiology: Concise Review for USMLE and General Medical Boards
Review all up-to-date high-yield cardiology in our book "Fundamentals of Cardiology"

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