Thromboangiitis Obliterans

What is Thromboangiitis Obliterans?

Thromboangiitis obliterans (TAO) is a rare non-atherosclerotic inflammatory vaso-occlusive disease of the small distal arteries and veins of the upper and lower extremities. The condition most commonly affects young or middle-aged men who are cigarette smokers or heavy alcohol users. Signs and symptoms typically include progressive pain, intermittent claudication, and sometimes skin ulcerations and gangrene in more advanced cases.

Cause of Thromboangiitis Obliterans

The cause of TAO is unknown, but the condition appears to be related to the repetitive mechanical injury that accompanied by a state of local biochemical inflammation. Other factors, such as smoking, alcohol consumption, and other environmental toxins, may play a role in the development of TAO.

Signs and Symptoms of Thromboangiitis Obliterans

  • Pain in the affected limb
  • Cold intolerance
  • Aching or burning sensation
  • Night cramps of affected limb
  • Intermittent claudication
  • Ulcerations
  • Gangrene

Diagnosis of Thromboangiitis Obliterans

The diagnosis of TAO is made based on clinical signs and symptoms in combination with confirmatory laboratory studies and imaging tests. Blood tests may indicate inflammation and an elevated white blood count. Characteristic non-invasive imaging tests for TAO include angiography, ultrasonography, and magnetic resonance angiography.

Treatment of Thromboangiitis Obliterans

The mainstay of treatment for TAO is discontinuation of smoking and, in some cases, improving alcohol consumption. Non-pharmacological measures, such as compression, elevation, and proper wound care may be used to reduce pain, swelling, and reduce the risk of ulcerations and infection. Pharmacological therapy may include anticoagulant drugs, antiplatelet agents, and elastase inhibitors. In more advanced cases, surgical debridement or revascularization may be needed.