Buerger'S Disease/Thromboangiitis Obliterans: Blood Tests

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BUERGERS DISEASE/THROMBOANGIITIS OBLITERANS

DEFINITION Thromboangiitis obliterans is a nonatherosclerotic, segmental, inflammatory, vasoocclusive disease that affects the small and medium-sized arteries and veins of the upper and lower extremities. ETIOLOGY 1. 2. unknown Heavy smoking

CLINICAL MANIFESTATIONS 1 The hands and feet are usually cool. 2 skin is pale, or cyanosis. 3 Paresthesias. 4 pain in limbs, intermittent claudication 5. Superficial thrombophlebitis LABORATORY and/or DIAGNOSTIC TESTS 1. Blood tests 2. Duplex ultrasonography 3. Contrast angiography MEDICAL MANAGEMENT First stage: local ischemic stage Second stage: nutritional ischemic stage Third stage: necrotic stage

1. Drug Thrapy
a. Prostaglandins Prostaglandin I2 (ilioprost) has antiplatelet and vasodilator activity. b. Dextran It Cause hemodilution, decrease blood viscosity and improve microcirculation. c. Praxiline (Niftidrofuryloxalate) It alter tissue metabolism, increase claudication distance by allowing a greater O2 supply to tissue no proved benefit. d. Trental (oxypentifylline) It has effect on whole blood viscosity by reducing it. 2. Physiotherapy 3. Amputation - if any gangrene 4. Vascular surgery
NURSING MANAGEMENT 1. 2. 3. 4. 5. 6. assessing for pain obtaining segmental blood pressure assessing for signs of ulcer formation assessing for signs of gangrene Quit smoking Lifestyle modification

ETIOLOGY - Unknown PRECIPITATING FACTORS - smoking

PATHOPHYSIOLOGY OF BUERGERS DISEASE/THROMBOANGIITIS OBLITERANS Plaques/Deposits of Nicotine on the veins or artery

Hypersensitivity reaction to tobacco products or autoimmune elements

Inflammation of the small and medium-sized arteries and veins of the extremities

Thickened artery and veins of the extremities

Inflammatory factors (neutrophils, lymphocytes and others) migrates to the inflamed artery or vein

Platelets deposits on the thickened artery and veins

Micro abscess formation

Fibrinoid occlusion

Luminal thrombotic occlusion

Impaired blood circulation

Early Signs and Symptoms Claudication type of pain Color Changes (Pallor) Temperature changes Cold Sensitivity (Reynauds phenomena) Ulceration Gangrene

Ischemia Injury Necrosis

Advance/Late Signs and Symptoms Thrombophlebitis with trauma Ulceration Gangrene Pulsation of the posterior tibial and dorsalis pedis arteries are weak or absent. Color Changes (Cyanotic) Edema of the Legs

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