Clinical Study of Phlebitis Migrans and Incompetence of the Leg's Superficial Vein in Buerger Disease

Abstract

Three of four (75%) vein biopsy samples from four patients (all male, mean onset: age 33.0, mean biopsy: age 59.7) of chronic phase phlebitis migrans showed positive periodontal bacteria DNA under the PCR (polymerase chain reaction) method. Of the 24 cases of Buerger disease (22 males, 2 females, mean onset: age 31.9, mean examination: age 62.6) that were investigated in our vascular laboratory, 65% of the patients suffered from moderate to severe varicose veins. Eight cases had a history of phlebitis migrans and three had an active ulcer or uncontrollable erosion in the foot. The rate of incidence was significantly higher than that of the wellmatched control group. Other findings included one instance of deep vein thrombosis, and one instance of deep vein reflux. We could suggest that some intractable ulcer or erosion cases of Buerger disease may be complicated by superficial vein incompetence or other deep vein insufficiency. We also we need to check Buerger disease patients with duplex for vein reflux and other insufficiencies.

Thromboangiitis Obliterans (Buerger’s Disease)—Current Practices

“…The oral specimen was the same as that detected in the vessels [17]. The phlebitic lesions of TAO show also oral bacterial DNA by the PCR method [18]. The bacterial transportation system was almost clear in the transmission electron microscopic examination [19].…”

Are There Any Objections against Our Hypothesis That Buerger Disease Is an Infectious Disease?

“…3). 4,10) Cigarette smoking clearly worsens the periodontal condition as reported in several papers. [13][14][15][16] The fact that periodontitis worsens the endothelial function was reported in the New England Journal of Medicine in 2007.…”

“…12). We found the oral bacteria DNA in the phlebitis migrans samples 10) and also in the primary varicose veins. 37) However, patients who take care of themselves can engage in sports.…”

“…1). 9) HypotHEsIs Figure 2 10) shows the scheme of our hypothesis. Multiple species of oral bacteria, which are weak, easily enter the bloodstream from the venous angle in the neck via lymph vessels around the mouth.…”

“…36) The hypothesis states that a periodontal bacterial infection passing through the valve region will result in phlebitis migrans or vein incompetence. 10) Phlebitis migrans appeared in clinical practice, in 40% of the cases.…”