Arterial.6.Buerger's disease Flashcards
Definition of Buerger’s disease
It is a clinical syndrome of severe chronic inflammation of the entire neurovascular bundle of the small blood vessels of L.L & hands.
Alternative name for Buerger’s disease
thrombo-angitis obliterans
ETIOLOGY of Buerger’s disease
The etiology is unknown.
The disease occurs exclusively in smokers, it may represent an allergic response nicotine.
Gender affected in Buerger’s disease
Buerger’s disease affects males only.
Difference between Atherosclerosis and Buerger’s disease
- Age of start
- Gender
- Etiology
- Level of lesion
Age of start of Atherosclerosis in Difference between Atherosclerosis and Buerger’s disease
Elderly
Age of start of Buerger disease in Difference between Atherosclerosis and Buerger’s disease
20-40 years
Gender of Atherosclerosis in Difference between Atherosclerosis and Buerger’s disease
Commoner in males
Gender of Buerger disease in Difference between Atherosclerosis and Buerger’s disease
Exclusively in males
Etiology of Atherosclerosis in Difference between Atherosclerosis and Buerger’s disease
Main risk factors are
- Hypertension
- High cholesterol
- DM.
Etiology of Buerger disease in Difference between Atherosclerosis and Buerger’s disease
Excessive smoking
Level of lesion in Atherosclerosis in Difference between Atherosclerosis and Buerger’s disease
Aorto-iliac
or
Femoro-popliteal
Level of lesion in Buerger disease in Difference between Atherosclerosis and Buerger’s disease
Distal vessels with patchy distribution
CLINICAL PICTURE of Buerger’s disease
As chronic L.L ischemia of Atherosclerosis with the following differences:
The disease is suspected When a young male who is heavy smoker complains of chronic ischaemia in one or more limbs
Rest pain is an early feature & trophic changes are common
The disease may be accompanied by migrating thrombophlebitis and 2ry v.v.
Raynaud’s phenomenon may be superimposed.
Investigations of Buerger’s disease
Arteriography is rarely necessary to confirm the diagnosis.
Arteriography in Investigations of Buerger’s disease
- Indications
- The reason why it’s rarely necessary to confirm the diagnosis
- Finding
Indications of Arteriography in Investigations of Buerger’s disease
Arteriography is rarely necessary to confirm the diagnosis.
The reason why it’s rarely necessary to confirm the diagnosis in Arteriography in Investigations of Buerger’s disease
- This is because the disease affects distal vessels and distal run off is known to be absent.
- Therefore there is no possibility for arterial reconstruction, and consequently no need for arteriography
Finding of Arteriography in Investigations of Buerger’s disease
it appears as corkscrew vessels in arteriography
Treatment of buerger’s disease
- Mainly conservative
- smoking must be stopped
- Lumbar sympathectomy
- Amputation of one or more digits or toes
Lumbar sympathectomy in Treatment of buerger’s disease
- Indication
* Disadvantages
Indication of Lumbar sympathectomy in Treatment of buerger’s disease
in cases of :
- Persistent ulcers
- Trophic changes & rest pain.
Disadvantages of Lumbar sympathectomy in Treatment of buerger’s disease
Lumbar sympathectomy is not done routinely as it will open the cutaneous blood vessels and thus the blood will be shifted from the muscles to skin leading to muscle necrosis
(stealing phenomenon)
stealing phenomenon
opening of the cutaneous blood vessels due to lumbar sympathectomy and thus the blood will be shifted from the muscles to skin leading to muscle necrosis
Amputation of one or more digits or toes in Treatment of buerger’s disease
- Indication
- Procedures
- Prognosis
Indication of Amputation of one or more digits or toes in Treatment of buerger’s disease
Persisting pain or gangrene
Procedures of Amputation of one or more digits or toes in Treatment of buerger’s disease
can be performed adjacent to the line of demarcation
Prognosis of Amputation of one or more digits or toes in Treatment of buerger’s disease
Satisfactory primary healing.
