Did the Clinical Spectrum of Thromboangiitis Obliterans Change in the Past 40 Years?

Abstract

<jats:p> Thromboangiitis obliterans (TAO) is an inflammatory disease that usually affects small and medium-sized arteries in the upper and lower limbs of young smokers. Previous studies showed that the spectrum TAO has changed in the 80s: the male-to-female ratio decreased, older patients were diagnosed, and upper limb involvement was more common. The aim of our study was to assess the changing clinical spectrum of TAO in France during the past 40 years. All consecutive patients fulfilling TAO’s criteria between January 1967 and January 2016 were retrospectively included in 3 departments of internal medicine. We compared TAO features in patients diagnosed before and after 2002; 141 (77.5%) men and 41 (22.5%) women were included. Patients diagnosed after 2002 were older (37 [31-39] vs 34 [29-35] years P = .03), had a more frequent isolated upper limb involvement (34.3% vs 7.8% P = .001), and less frequent isolated lower limb involvement (55.7% vs 74.5%, P &lt; .001). The clinical spectrum of TAO has changed in France since the beginning of the 21st century. </jats:p>

Under-Prescription of Medical Treatment for Peripheral Artery Disease in the Under 50s: A Retrospective Study

“…11 The epidemiology of Buerger disease is decreasing in Western countries, with a changing clinical spectrum as more upper limb involvement. 12,13 Our data are similar to the recent literature on Buerger disease as a limited part of PAD in young patients. Antiphospholipid syndrome was present in 5 patients (5.7%).…”

“…Cannabis arteritis of lower limbs has been described independently of tobacco use, 16 with a more proximal presentation and more upper limb involvement but closely linked to Buerger disease. 12,17 Moreover, cannabis use is associated with poorer in-hospital outcomes. 18 This condition is often under-recognized, and cannabis consumption cessation is a specific therapeutic aim.…”

Management of Buerger’s disease during pregnancy

“…The most potent risk factor in developing BD is tobacco smoking 2. Additional risk factors are mentioned in box 1 1 3 4…”

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

“…These findings on the survival rates are understandable, because the current standard therapy of BD—abstinence from tobacco, prostacyclin analogs, platelet inhibitors, vasodilators, and various surgical techniques—alleviates only vascular narrowing of the limbs and may not ameliorate the systemic cause(s). BD in women was rare in the past [ 3 ]; however, since the 1970s, women have been observed to suffer from BD increasingly in the United States (23.0%) and France (24.0%) [ 54 55 ], which seems to be related to their increased use of tobacco (26.2% in men vs. 15.7% in women in the United States) [ 56 ]. Recently, BD is occasionally diagnosed first in the elderly population, which may be related to the increased number of nonsmoking men.…”

“…Recently, BD is occasionally diagnosed first in the elderly population, which may be related to the increased number of nonsmoking men. Upper limb involvement is also more commonly observed [ 54 55 ]. Furthermore, various doses of nicotine when administered orally or intravenously to experimental rabbits induce no pathological or necrotic changes of the aorta rather than the inflammatory changes.…”