Obliterating thromboangiitis is a chronic inflammatory disease of , the main impact of which falls on veins and vessels of small or medium size.
The main risk group is young men. First they complain of puffiness and pain in their legs, gradually numbness, cramps, necrosis, gangrene or foot ulcers caused by a violation of blood circulation in the tissues and vessels of the feet.
Conservative treatment is not always effective, and surgical treatment is most often used for amputations.
For the first time a description of the narrowing of the arteries of the legs with simultaneous presence of thromboses and inflammatory vascular proliferation was described by Vinivarter Burger. The doctor was looking for the cause of the development of spontaneous gangrene, which inevitably leads to leg amputation.
Burger's attention was drawn to the form of artery disease, which is chosen for arteries and veins, the lower limbs are predominantly young people.
Contents of
- What are the true causes of pathology?
- Classification of the disease
- Symptoms and signs of each stage
- Diagnostic techniques
- Diseases treatment
- First stage
- Treatment of pathology in the second stage
- Stage three - the most dangerous
- Possible complications
- Pathology prevention
- Conclusions
What are the true causes of the pathology?
No expert can boast of knowledge of the causes of the development of Burger's disease.
At the moment, doctors can only assume the likelihood of development in different groups of people on the basis of observations conducted for several decades. And the first thing that each of the doctors will say is that the disease was registered only with smokers.
Among the other risk factors is the increased function of the adrenal glands.excess adrenaline provokes a spasm of the microcirculation system.
Changes in nerve trunks can cause thrombus formation or blockage of peripheral arteries, determining a neurogenic factor. There is also a damage factor, for example, after severe allergic reactions, poisoning or frostbite, and experienced injuries.
It is believed that the supercooling factor in this group is the most significant. You can not exclude genetic predisposition to the development of the disease.
How effective is treatment of veins with the help of waves or radiofrequency obliteration? What you need to know before going through the procedures tells our article.
Pregnant women may have genetic thrombophilia. What is the peculiarity of the pathology and what needs to be known about this disease.
Classification of the disease
The burger disease is classified in several ways.
From the point of view of the development of the disease, it is defined as:
- is rapidly progressive( gangrene of the extremities comes in the shortest possible time);
- is slowly progressing( light intervals occur periodically, their duration is from several months to several years).
Classification based on localization of changes:
- peripheral refers to the option of attacking the vessels of the limbs;
- if the course is additionally accompanied by coronary symptoms or thrombosis of mesentery vessels, then it is already a visceral or mixed form.
In the photo, the characteristic symptoms of Buerger's disease are dead tissues of the
limb. An area of the arterial bed, in which there are obstructions to blood flow, is also important for classification.
In most cases, obliteration of small arteries is recorded. This type is called distal, it is characteristic for the vessels of the feet, forearms, brushes and tibia.
When lesions of large arteries like the femoral or iliac type of disease is defined as proximal.
It accounts for about 17% of cases.
With the same periodicity, doctors are confronted with a mixture of the two types, which made them stand out separately as part of the classification. The name is simple - a mixed type.
Symptoms and signs of each stage
Burger's disease has characteristic symptoms. The main one is severe pain on the lesions, most often intensifying at night.
The disease affects both the upper and lower extremities simultaneously; the following syndromes are observed:
- muscle atrophy and puffiness;
- appearance of hemorrhages on the finger pads;
- further formation of painful knots;
- extremities begin to react sharply to a decrease in temperature;
- , in addition to unpleasant sensations, there is a sharp pallor.
Each of the stages of the pathology development has its own set of symptoms:
- The first signs of the disease are the appearance of aching sensations, which are replaced by hot clusters in the vessels. The calf and calf muscles experience additional stress, which is expressed by the severity and rapid fatigue. Burning sensation or a slight tingling is recorded in the toes or the entire foot.
- The second stage of is characterized by numbness of the fingers and the most characteristic symptom in the form of intermittent claudication. The appearance of gangrene of fingers and deep necrosis indicates the transition of the disease to the third stage.
Diagnostic techniques
Diagnosis of Buerger's disease usually occurs by an exclusive method.
If in the course of the research it is not possible to write off the blame for another disease, then for people younger than 45 years the diagnosis is confirmed. Blood tests can exclude the presence of diabetes, vasculitis. The rate of blood coagulability, platelet aggregation is studied.
In the laboratory, studies are conducted on antibodies to phospholipids. The skin is subjected to thermography and thermometry, so it is possible to identify the features of the circulation of the lower extremities, to identify the areas of failure.
The patient then undergoes an ultrasound examining the characteristics of the disorders. Presence of symptoms of the disease does not mean its presence.
A huge number of diseases can provoke such symptoms, therefore, a huge number of different studies are required to make sure that the lower extremities obliterating thrombophlebitis is treated.
Complexities of treatment of
disease There is no single-valued and effective treatment of the disease at this time. Given the leading role of nicotine in the development of thrombophlebitis, the patient will immediately have to abandon the addiction.
Simultaneously, the course of therapy includes dosed walking.
Medication support consists of antispasmodics, ganglion blockers and nicotinic acid to relieve vasospasms and sedatives with anxiolytics to restore the natural functioning of the central nervous system.
A doctor may be prescribed a course of antibiotics when a secondary infection is detected. Blood clotting is regulated by anticoagulants like kleksana or heparin.
Reduced blood fluidity is corrected by taking aspirin and clopidogrel as prescribed by your doctor. Operative treatment can be applied at any stage of the disease.
The first stage of
The first stage allows the use of thoracic or lumbar sympathectomy. The objectives of the method include getting rid of peripheral spasm and organizing a roundabout blood supply.
Treatment of pathology in the second stage
In the second stage, the surgical treatment is determined by reconstructive operations of autovenous shunting, endarterectomy and alloprosthetics.
In practice, their assignment occurs only in some cases, becausethe disease is associated with the defeat of the subcutaneous veins and the simultaneous absence of outflow pathways.
The presence of two of the above factors increases the risk of thrombosis formation. If the operation has still been carried out, the patient will have a course of prolonged intra-arterial infusion. The least likely is endarterectomy.
Removal of the vessel walls does not guarantee disposal of all inflammation foci. In the future, the process can resume.
Stage three - the most dangerous
The third stage of the disease is associated with gangrene of the extremities.
Doctors conduct a thorough analysis of the condition of the arteries, on the basis of which the operation for reconstructing the vessels is prescribed or amputation is performed. Limb amputation is the most common variant of operations at this stage.
Possible complications of
Progressive disease is characterized by a limited set of possible complications. Among them:
- venous thrombosis;
- arterial thrombosis;
- gangrene.
Doctors predominantly prescribe an amputation, depriving the patient of the limb, but while preserving life.
Prevention of pathology
Quitting smoking reduces the risk of developing the disease to a minimum. To ensure the safety of your health, serious consideration should be given to the 
questions about the choice of footwear.
The preservation of healthy circulation of the feet is a defense against many diseases, not just thrombangiitis.
Daily walks with simultaneous exclusion of long standing on the feet during the day protects from stagnation of blood and microcirculation disorders. In the cold season it is necessary to protect the legs from hypothermia.
An important element of prevention is proper nutrition. Healthy food, carrying only the necessary elements to strengthen blood vessels and immunity protects better than any chemical. Moreover, this type of protection is very simple and even enjoyable.
The huge amount of energy released after a healthy meal requires a rational exit in the form of sports. Suitable is any kind, strengthening vessels, even yoga.
Conclusions
Buerger's disease is dangerous for smokers under the age of 45 years, disrupting the circulatory system in the limbs under the influence of aggravating factors quickly leads to the development of serious complications.
The risk of diagnosis is due to the lack of a unified treatment system and a high rate of amputation treatment.