{"id":9644,"date":"2021-12-28T17:54:54","date_gmt":"2021-12-28T15:54:54","guid":{"rendered":"https:\/\/meddists.com\/learn\/clinical\/internal-medicine\/cardiology\/peripheral-arterial-occlusion-acute-and-chronic-buergers-disease-thrombangiitis-obliterans\/"},"modified":"2022-02-02T23:56:34","modified_gmt":"2022-02-02T21:56:34","slug":"peripheral-arterial-occlusion-acute-and-chronic-buergers-disease-thrombangiitis-obliterans","status":"publish","type":"page","link":"https:\/\/meddists.com\/learn\/clinical\/internal-medicine\/cardiology\/peripheral-arterial-occlusion-acute-and-chronic-buergers-disease-thrombangiitis-obliterans\/","title":{"rendered":"Peripheral arterial occlusion (acute and chronic). Buerger\u2019s disease (thrombangiitis obliterans)"},"content":{"rendered":"<span class=\"block-heading\" id=\"header_1\">\n<h3 class=\"wp-block-heading\" id=\"acute-peripheral-arterial-occlusion\" class=\"wp-block-heading\" id=\"acute-peripheral-arterial-occlusion\" class=\"title_collection title1\">Acute peripheral arterial occlusion<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_1\">\n\n<\/span><span class=\"block-heading\" id=\"header_2\">\n<h4 class=\"wp-block-heading\" id=\"etiology\" class=\"wp-block-heading\" id=\"etiology\" class=\"title_collection title2\">Etiology<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_2\">\n\n\n<ul class=\"wp-block-list\"><li>Thrombosis<\/li><li>Embolus<\/li><li>Compartment syndrome<\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_3\">\n<h4 class=\"wp-block-heading\" id=\"symptoms\" class=\"wp-block-heading\" id=\"symptoms\" class=\"title_collection title2\">Symptoms<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_3\">\n\n\n<p class=\"wp-block-paragraph\">The 4 P&#8217;s:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Pain<\/li><li>Pallor and coldness<\/li><li>Paresthesia<\/li><li>Pulselessness<\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_4\">\n<h4 class=\"wp-block-heading\" id=\"diagnosis\" class=\"wp-block-heading\" id=\"diagnosis\" class=\"title_collection title2\">Diagnosis<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_4\">\n\n\n<ul class=\"wp-block-list\"><li>Physical examination (lack of pulse distral to the occlusion)<\/li><li>Angiography <\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_5\">\n<h4 class=\"wp-block-heading\" id=\"treatment\" class=\"wp-block-heading\" id=\"treatment\" class=\"title_collection title2\">Treatment<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_5\">\n\n\n<p class=\"wp-block-paragraph\">Depending on the location and severity:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Thrombolysis<\/li><li>Thrombectomy<\/li><li>Embolectomy<\/li><li>Bypass surgery<\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_6\">\n<h3 class=\"wp-block-heading\" id=\"peripheral-arterial-disease\" class=\"wp-block-heading\" id=\"peripheral-arterial-disease\" class=\"title_collection title1\">Peripheral arterial disease<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_6\">\n\n\n<p class=\"wp-block-paragraph\">PAD is the occlusion of peripheral vessels caused due to atherosclerosis, leading to reduced blood perfusion and ischemia.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Usually affects the lower limb (superficial femoral artery is the most common location).<\/li><li>Depending on the severity of the occlusion, it may be asymptomatic, or cause <strong>intermittent claudication<\/strong>, pain, atrophy, local hairloss, and ulcers.<\/li><li>Typically appears with other atherosclerosis-related diseases such as CAD.<\/li><li>Contributing factors include smoking, dyslipidemia, HTN, diabetes.<\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_7\">\n<h4 class=\"wp-block-heading\" id=\"diagnosis\" class=\"wp-block-heading\" id=\"diagnosis\" class=\"title_collection title2\">Diagnosis<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_7\">\n\n\n<ul class=\"wp-block-list\"><li><strong>Physical examination.<\/strong> Walking test (see <strong>Classification<\/strong>). Elevating the leg leads to paleness and pain (in advanced PAD).<\/li><li><strong>Ankle-brachial index<\/strong>. Normal value 1.0-1.3; PAD usually shows values below 0.8<\/li><li>US<\/li><li>Angiography<\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_8\">\n<h4 class=\"wp-block-heading\" id=\"classification-systems\" class=\"wp-block-heading\" id=\"classification-systems\" class=\"title_collection title2\">Classification systems<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_8\">\n\n\n<p class=\"wp-block-paragraph\">The <strong>Fontaine classification<\/strong> describes the severity of the occlusion based on the symptoms:<\/p>\n\n\n\n<ol class=\"wp-block-list\"><li><strong>Stage I<\/strong>. Asymptomatic<\/li><li><strong>Stage IIa<\/strong>. Claudication at a distance\u2009>\u2009200 m<\/li><li><strong>Stage IIb<\/strong>. Claudication at a distance\u2009&lt;\u2009200 m<\/li><li><strong>Stage III<\/strong>. Pain at rest<\/li><li><strong>Stage IV<\/strong>. Ulcer\/gangrene<\/li><\/ol>\n\n\n<\/span><span class=\"block-heading\" id=\"header_9\">\n<h4 class=\"wp-block-heading\" id=\"treatment\" class=\"wp-block-heading\" id=\"treatment\" class=\"title_collection title2\">Treatment<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_9\">\n\n\n<ul class=\"wp-block-list\"><li>Lifestyle modifications (weight loss, diet, exercise, smoking cessation)<\/li><li>Avoid leg elevation and drugs that induce vasoconstriction (decongestants)<\/li><li>Wound care in case of ulcers<\/li><li>Statins (atorvastatin 20mg\/day)<\/li><li>Dual-antiplatelet medication (aspirin 100mg\/day, prasugrel 10mg\/day)<\/li><li>Percutanous transluminal angioplasty<\/li><li>Surgery (angioplasty with\/without stenting, bypass grafting)<\/li><li>Amputation<\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_10\">\n<h3 class=\"wp-block-heading\" id=\"buerger-s-disease\" class=\"wp-block-heading\" id=\"buerger-s-disease\" class=\"title_collection title1\">Buerger&#8217;s disease<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_10\">\n\n\n<p class=\"wp-block-paragraph\">Buerger&#8217;s disease is a type of vasculitis characterized by progressive inflammation and thrombosis of small to medium vessels, highly associated with smoking.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>The typical patient is a young male smoker.<\/li><li>Typically affects the vessels of the distal limbs (mostly tibial and radial arteries), leading to ischemia and superficial thrombophlebitis, and their obliteration, and nerve involvement which leads to severe pain (hence, known as <strong>thromboangiitis obliterans<\/strong>). <\/li><li>Presents with limb coldness, paleness, tingling, pain, intermittent claudication, and sometimes ulceration.<\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_11\">\n<h4 class=\"wp-block-heading\" id=\"diagnosis\" class=\"wp-block-heading\" id=\"diagnosis\" class=\"title_collection title2\">Diagnosis<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_11\">\n\n\n<ul class=\"wp-block-list\"><li>Physical examination <ul><li>Peripheral pulse is reduced\/absent. <\/li><li>Positive Allen test (paleness remains after the compression and release of radial &amp; ulnar arteries)<\/li><\/ul><\/li><li>Ankle-brachial index<\/li><li>Ultrasound<\/li><li>Serology (to exclude other vasculitides and antiphospholipid syndrome)<\/li><li>Angiography<\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_12\">\n<h4 class=\"wp-block-heading\" id=\"treatment\" class=\"wp-block-heading\" id=\"treatment\" class=\"title_collection title2\">Treatment<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_12\">\n\n\n<ul class=\"wp-block-list\"><li>Smoking cessation<ul><li>Does not improve well-established lesions, but prevents worsening and appearence of new ones.<\/li><\/ul><\/li><li>Wound care in case of ulcers<\/li><li>Avoid cold weather and drugs that induce vasoconstriction (decongestants)<\/li><li>Prostacyclin analogues (iloprost)<\/li><li>Amputation<\/li><\/ul>\n<\/span><div id=\"the_titles\" style=\"display:none;\"><h3 class=\"wp-block-heading\" id=\"acute-peripheral-arterial-occlusion\" class=\"wp-block-heading\" id=\"acute-peripheral-arterial-occlusion\">Acute peripheral arterial occlusion<\/h3><h4 class=\"wp-block-heading\" id=\"etiology\" class=\"wp-block-heading\" id=\"etiology\">Etiology<\/h4><h4 class=\"wp-block-heading\" id=\"symptoms\" class=\"wp-block-heading\" id=\"symptoms\">Symptoms<\/h4><h4 class=\"wp-block-heading\" id=\"diagnosis\" class=\"wp-block-heading\" id=\"diagnosis\">Diagnosis<\/h4><h4 class=\"wp-block-heading\" id=\"treatment\" class=\"wp-block-heading\" id=\"treatment\">Treatment<\/h4><h3 class=\"wp-block-heading\" id=\"peripheral-arterial-disease\" class=\"wp-block-heading\" id=\"peripheral-arterial-disease\">Peripheral arterial disease<\/h3><h4 class=\"wp-block-heading\" id=\"diagnosis\" class=\"wp-block-heading\" id=\"diagnosis\">Diagnosis<\/h4><h4 class=\"wp-block-heading\" id=\"classification-systems\" class=\"wp-block-heading\" id=\"classification-systems\">Classification systems<\/h4><h4 class=\"wp-block-heading\" id=\"treatment\" class=\"wp-block-heading\" id=\"treatment\">Treatment<\/h4><h3 class=\"wp-block-heading\" id=\"buerger-s-disease\" class=\"wp-block-heading\" id=\"buerger-s-disease\">Buerger&#8217;s disease<\/h3><h4 class=\"wp-block-heading\" id=\"diagnosis\" class=\"wp-block-heading\" id=\"diagnosis\">Diagnosis<\/h4><h4 class=\"wp-block-heading\" id=\"treatment\" class=\"wp-block-heading\" id=\"treatment\">Treatment<\/h4><\/div>","protected":false},"excerpt":{"rendered":"<p>Acute peripheral arterial occlusion Etiology Thrombosis Embolus Compartment syndrome Symptoms The 4 P&#8217;s: Pain Pallor and coldness Paresthesia Pulselessness Diagnosis Physical examination (lack of pulse distral to the occlusion) Angiography Treatment Depending on the location and severity: Thrombolysis Thrombectomy Embolectomy Bypass surgery Peripheral arterial disease PAD is the occlusion of peripheral vessels caused due to [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":410,"menu_order":25,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-9644","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.9 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Peripheral arterial occlusion (acute and chronic). Buerger\u2019s disease (thrombangiitis obliterans) &#8211; Meddists<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/meddists.com\/learn\/clinical\/internal-medicine\/cardiology\/peripheral-arterial-occlusion-acute-and-chronic-buergers-disease-thrombangiitis-obliterans\/\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/meddists.com\\\/learn\\\/clinical\\\/internal-medicine\\\/cardiology\\\/peripheral-arterial-occlusion-acute-and-chronic-buergers-disease-thrombangiitis-obliterans\\\/\",\"url\":\"https:\\\/\\\/meddists.com\\\/learn\\\/clinical\\\/internal-medicine\\\/cardiology\\\/peripheral-arterial-occlusion-acute-and-chronic-buergers-disease-thrombangiitis-obliterans\\\/\",\"name\":\"Peripheral arterial occlusion (acute and chronic). Buerger\u2019s disease (thrombangiitis obliterans) &#8211; Meddists\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/meddists.com\\\/learn\\\/#website\"},\"datePublished\":\"2021-12-28T15:54:54+00:00\",\"dateModified\":\"2022-02-02T21:56:34+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/meddists.com\\\/learn\\\/clinical\\\/internal-medicine\\\/cardiology\\\/peripheral-arterial-occlusion-acute-and-chronic-buergers-disease-thrombangiitis-obliterans\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/meddists.com\\\/learn\\\/clinical\\\/internal-medicine\\\/cardiology\\\/peripheral-arterial-occlusion-acute-and-chronic-buergers-disease-thrombangiitis-obliterans\\\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/meddists.com\\\/learn\\\/clinical\\\/internal-medicine\\\/cardiology\\\/peripheral-arterial-occlusion-acute-and-chronic-buergers-disease-thrombangiitis-obliterans\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"http:\\\/\\\/meddists.com\\\/learn\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Clinical\",\"item\":\"https:\\\/\\\/meddists.com\\\/learn\\\/clinical\\\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Internal medicine\",\"item\":\"https:\\\/\\\/meddists.com\\\/learn\\\/clinical\\\/internal-medicine\\\/\"},{\"@type\":\"ListItem\",\"position\":4,\"name\":\"Cardiology\",\"item\":\"https:\\\/\\\/meddists.com\\\/learn\\\/clinical\\\/internal-medicine\\\/cardiology\\\/\"},{\"@type\":\"ListItem\",\"position\":5,\"name\":\"Peripheral arterial occlusion (acute and chronic). Buerger\u2019s disease (thrombangiitis obliterans)\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/meddists.com\\\/learn\\\/#website\",\"url\":\"https:\\\/\\\/meddists.com\\\/learn\\\/\",\"name\":\"Meddists\",\"description\":\"Let&#039;s Get Studying\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/meddists.com\\\/learn\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Peripheral arterial occlusion (acute and chronic). Buerger\u2019s disease (thrombangiitis obliterans) &#8211; Meddists","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/meddists.com\/learn\/clinical\/internal-medicine\/cardiology\/peripheral-arterial-occlusion-acute-and-chronic-buergers-disease-thrombangiitis-obliterans\/","twitter_misc":{"Est. reading time":"2 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/meddists.com\/learn\/clinical\/internal-medicine\/cardiology\/peripheral-arterial-occlusion-acute-and-chronic-buergers-disease-thrombangiitis-obliterans\/","url":"https:\/\/meddists.com\/learn\/clinical\/internal-medicine\/cardiology\/peripheral-arterial-occlusion-acute-and-chronic-buergers-disease-thrombangiitis-obliterans\/","name":"Peripheral arterial occlusion (acute and chronic). Buerger\u2019s disease (thrombangiitis obliterans) &#8211; Meddists","isPartOf":{"@id":"https:\/\/meddists.com\/learn\/#website"},"datePublished":"2021-12-28T15:54:54+00:00","dateModified":"2022-02-02T21:56:34+00:00","breadcrumb":{"@id":"https:\/\/meddists.com\/learn\/clinical\/internal-medicine\/cardiology\/peripheral-arterial-occlusion-acute-and-chronic-buergers-disease-thrombangiitis-obliterans\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/meddists.com\/learn\/clinical\/internal-medicine\/cardiology\/peripheral-arterial-occlusion-acute-and-chronic-buergers-disease-thrombangiitis-obliterans\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/meddists.com\/learn\/clinical\/internal-medicine\/cardiology\/peripheral-arterial-occlusion-acute-and-chronic-buergers-disease-thrombangiitis-obliterans\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"http:\/\/meddists.com\/learn\/"},{"@type":"ListItem","position":2,"name":"Clinical","item":"https:\/\/meddists.com\/learn\/clinical\/"},{"@type":"ListItem","position":3,"name":"Internal medicine","item":"https:\/\/meddists.com\/learn\/clinical\/internal-medicine\/"},{"@type":"ListItem","position":4,"name":"Cardiology","item":"https:\/\/meddists.com\/learn\/clinical\/internal-medicine\/cardiology\/"},{"@type":"ListItem","position":5,"name":"Peripheral arterial occlusion (acute and chronic). Buerger\u2019s disease (thrombangiitis obliterans)"}]},{"@type":"WebSite","@id":"https:\/\/meddists.com\/learn\/#website","url":"https:\/\/meddists.com\/learn\/","name":"Meddists","description":"Let&#039;s Get Studying","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/meddists.com\/learn\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"}]}},"_links":{"self":[{"href":"https:\/\/meddists.com\/learn\/wp-json\/wp\/v2\/pages\/9644","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/meddists.com\/learn\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/meddists.com\/learn\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/meddists.com\/learn\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/meddists.com\/learn\/wp-json\/wp\/v2\/comments?post=9644"}],"version-history":[{"count":11,"href":"https:\/\/meddists.com\/learn\/wp-json\/wp\/v2\/pages\/9644\/revisions"}],"predecessor-version":[{"id":10353,"href":"https:\/\/meddists.com\/learn\/wp-json\/wp\/v2\/pages\/9644\/revisions\/10353"}],"up":[{"embeddable":true,"href":"https:\/\/meddists.com\/learn\/wp-json\/wp\/v2\/pages\/410"}],"wp:attachment":[{"href":"https:\/\/meddists.com\/learn\/wp-json\/wp\/v2\/media?parent=9644"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}