Buerger Disease: Pathological Changes in Elderly Patients

Iwai, Takehisa; Kume, Hiroko; Koizumi, Satoshi; Sakurazawa, Kenichi; Honma, K.; Ogasawara, Hiroko; Takemura, Tamiko; Kishino, Mitsuhiro; Kagayama, Tomoko

doi:10.3400/avd.oa.21-00142

Cited by 4 publications

(2 citation statements)

References 20 publications

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“…The development of arteriosclerosis obliterans, a smoking-related disease, is a likely cause of amputation decades after TAO onset. 26 Therefore, smoking prevention and early detection of TAO before ulcers develop may lead to reduced likelihood of digits or extremity loss.…”

Section: Discussionmentioning

confidence: 99%

Demographic Traits, Clinical Status, and Comorbidities of Patients With Thromboangiitis Obliterans in Japan

Watanabe

Shimizu

Hashimoto

et al. 2023

Circ J

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Japan (published in 1993 20 and 2009 18 ). Moreover, several studies report limb loss outcomes, but little is known about the patients' clinical and living conditions. 19,21 The Japanese Ministry of Health, Labour and Welfare (JMHLW) holds an official nationwide database of patients with TAO to survey this disease. For registered patients, JMHLW covers part of the medical expenses. Using this database, we performed a cross-sectional analysis of the demographic parameters, clinical status, and living conditions of contemporary patients with TAO in Japan. Methods Study Design, Setting, and ParticipantsThis retrospective cross-sectional study was conducted by T hromboangiitis obliterans (TAO, Buerger's disease) is an inflammatory segmental thrombotic condition of medium-and small-sized arteries and veins in the distal extremities. It is a rare but intractable disease and mainly affects young smokers. 1-5 Although the use of tobacco products is considered the most significant risk factor for the initiation and progression of TAO, 6-11 its exact pathogenesis is obscure, and currently there are no curative treatments. 7,9,12-17 Furthermore, arterial revascularization is often challenging due to the small diameter and poor runoff of the vessels. Hence, many patients suffer from lifelong extremity ischemia and occasionally amputation of digits or limbs. Recent reports have shown that patients with TAO have a long life expectancy, 2,10,11,18,19 but demographic information is limited, 4,5 including from

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Section: Discussionmentioning

confidence: 99%

Demographic Traits, Clinical Status, and Comorbidities of Patients With Thromboangiitis Obliterans in Japan

Watanabe

Shimizu

Hashimoto

et al. 2023

Circ J

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“…Atherosclerotic plaque or fibrinoid necrosis is seldom observed in the arterial wall. However, as BD is increasingly diagnosed in elderly patients, atherosclerotic lesions are often observed in these patients [ 3 11 12 ]. The disease usually originates in the smaller vessels, such as the dorsalis pedis artery; subsequently, it ascends to the arteries above, sometimes with intervening normal segments.…”

Section: Overview Of Buerger’s Diseasementioning

confidence: 99%

Buerger’s Disease May be a Chronic Rickettsial Infection with Superimposed Thrombosis: Literature Review and Efficacy of Doxycycline in Three Patients

Chung¹,

Lee

Kang

2022

Infect Chemother

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Buerger’s disease (BD) is a chronic inflammatory vasculitis of unknown etiology. The infectious etiology of BD was proposed by Buerger in 1914. Furthermore, there are scattered reports insisting that BD may be related to rickettsial infection, first asserted by Goodman since 1916, followed by Giroud and other French investigators from the 1940s through the 1960s, Nicolau in the 1960s, Bartolo (1980s), and Fazeli (2010s). However, their causal relationship has hardly been accepted because rickettsial infections are known to be acute febrile, vector-borne illnesses, whereas BD is a chronic afebrile illness. In this article we review the relevant literature on the chronic nature of Rickettsia and Orientia infections and on the rickettsial etiology of BD. Excellent initial responses to doxycycline in three patients with BD are briefly described. Based on these findings, we hypothesize that BD patients acquired a rickettsial infection far before the onset of BD. Over years, the infected area expands to become a segment of the infected vessel. Subsequently, thrombus develops on the luminal surface of the infected endothelial cells, which produces the vascular obstructive manifestations of BD. Collectively, it is postulated that BD is a chronic infection with a member of the family Rickettsiaceae with superimposed thrombosis.

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Diagnostic criteria for Buerger's disease: International Consensus of VAS - European Independent Foundation in Angiology/Vascular Medicine

FAZELI,

POREDOS,

KOZAK

et al. 2023

Int Angiol

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Buerger Disease: Pathological Changes in Elderly Patients

Cited by 4 publications

References 20 publications

Demographic Traits, Clinical Status, and Comorbidities of Patients With Thromboangiitis Obliterans in Japan

Demographic Traits, Clinical Status, and Comorbidities of Patients With Thromboangiitis Obliterans in Japan

Buerger’s Disease May be a Chronic Rickettsial Infection with Superimposed Thrombosis: Literature Review and Efficacy of Doxycycline in Three Patients

Diagnostic criteria for Buerger's disease: International Consensus of VAS - European Independent Foundation in Angiology/Vascular Medicine

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