Landmark Publication from The American Journal of the Medical Sciences: Thrombo-Angiitis Obliterans: A Study of the Vascular Lesions Leading to Presenile Spontaneous Gangrene11Read at a meeting of the Association of American Physicians, Washington, D. C., May 12 and 13, 1908.

Buerger, Leo

doi:10.1097/maj.0b013e31818c8bc9

Cited by 40 publications

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“… 25 – 30 Giant cell formation and the appearance of the so-called microabscesses within the mono-nuclear cell-rich thrombus may occur. 2 …”

Section: Etiologic Pathologic and Pathogenetic Aspectsmentioning

confidence: 99%

“…In 1879, Winiwarter, 1 a young assistant physician of Theodor Billroth in Vienna, published the clinical course and pathologic examination of a lower limb amputation of a 57-year-old male describing “a peculiar kind of angiitis and endophlebitis with gangrene”. Although this is considered to be the first case report of thromboangiitis obliterans (TAO), the disease is currently more exclusively linked to the American surgeon Buerger 2 , whose systematic work on clinical and pathological aspects of the disease constituted our modern understanding of the disease.…”

Section: Introductionmentioning

confidence: 99%

“…TAO is an inflammatory vascular pathology affecting small- and medium-sized arteries and veins leading to vessel occlusions by the formation of a mononuclear cell-rich thrombus. 2 Its etiology is still unknown, but it is inseparably linked to tobacco use. Due to an undulating clinical course, normal vessel segments and different stages of lesions (acute to chronic types) might be found together in the same patient.…”

Section: Introductionmentioning

confidence: 99%

“…Due to an undulating clinical course, normal vessel segments and different stages of lesions (acute to chronic types) might be found together in the same patient. 2 …”

Section: Introductionmentioning

confidence: 99%

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Buerger’s disease: providing integrated care

Klein-Weigel¹,

Volz²,

Zange³

2016

JMDH

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Buerger’s disease, also known as thromboangiitis obliterans (TAO), is a segmental inflammatory disease affecting small- and medium-sized vessels, which is strongly associated with tobacco use. Although the etiology is still unknown, recent studies suggest an immunopathogenesis. Diagnosis is based on clinical and angiomorphologic criteria, including age, history of smoking, clinical presentation with distal extremity ischemia, and the absence of other risk factors for atherosclerosis, autoimmune disease, hypercoagulable states, or embolic disease. Until now, no causative therapy exists for TAO. The most important therapeutic intervention is smoking cessations and intravenous prostanoid infusions (iloprost). Furthermore, effective analgesia is crucial for the treatment of ischemic and neuropathic pain and might be expanded by spinal cord stimulation. Revascularization procedures do not play a major role in the treatment of TAO due to the distal localization of arterial occlusion. More recently, immunoadsorption has been introduced eliminating vasoconstrictive G-protein-coupled receptor and other autoantibodies. Cell-based therapies and treatment with bosentan were also advocated. Finally, a consequent prevention and treatment of wounds and infections are essential for the prevention of amputations. To achieve better clinical results, integrated care in multidisciplinary and trans-sectoral teams with emphasis on smoking cessation, pain control, wound management, and social care by professionals, social workers, and family members is necessary.

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“… 25 – 30 Giant cell formation and the appearance of the so-called microabscesses within the mono-nuclear cell-rich thrombus may occur. 2 …”

Section: Etiologic Pathologic and Pathogenetic Aspectsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Due to an undulating clinical course, normal vessel segments and different stages of lesions (acute to chronic types) might be found together in the same patient. 2 …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Buerger’s disease: providing integrated care

Klein-Weigel¹,

Volz²,

Zange³

2016

JMDH

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“…The disease was first described by Felix Von Winiwarter in 1879 but later named after Leo Buerger who, in 1908, provided a detailed pathological account in 11 amputated limbs. 1 Buerger’s disease predominantly develops in young to middle-aged male tobacco users, 2 , 3 and most investigators agree that exposure to tobacco, whether firsthand or secondhand, is a prerequisite for development of the disease. 4 In a recent Japanese study, however, up to 8% of patients identified as never smokers.…”

Section: Introductionmentioning

confidence: 99%

Therapeutic angiogenesis in Buerger’s disease: reviewing the treatment landscape

Ribieras

Ortiz

Liu

et al. 2022

Therapeutic Advances in Rare Disease

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Thromboangiitis obliterans, also known as Buerger’s disease, is a rare inflammatory vasculitis that predominantly develops in smokers and characteristically affects the small- and medium-sized peripheral arteries and veins. Patients typically present with extremity claudication, but symptoms may progress to rest pain and tissue loss, especially in those unable to abstain from tobacco use. Unfortunately, traditional medical treatments are largely ineffective and due to the small caliber of affected vessels and lack of suitable distal targets or venous conduits, endovascular and open surgical approaches are often not possible. Eventually, a significant number of patients require major amputation. For these reasons, much research effort has been made in developing techniques of therapeutic angiogenesis to improve limb perfusion, both for atherosclerotic peripheral arterial disease and the smaller subset of patients with critical limb ischemia due to Buerger’s disease. Neovascularization in response to ischemia relies on a complex interplay between the local tissue microenvironment and circulating stem and progenitor cells. To date, studies of therapeutic angiogenesis have therefore focused on exploiting known angiogenic factors and stem cells to induce neovascularization in ischemic tissues. This review summarizes the available clinical data regarding the safety and efficacy of various angiogenic therapies, notably injection of naked DNA plasmids, viral gene constructs, and cell-based preparations, and describes techniques for potentiating in vivo efficacy of gene- and cell-based therapies as well as ongoing developments in exosome-based cell-free approaches for therapeutic angiogenesis. Plain Language Title and Summary A review of available and emerging treatments for improving blood flow and wound healing in patients with Buerger’s disease, a rare disorder of blood vessels Buerger’s disease is a rare disorder of the small- and medium-sized blood vessels in the arms and legs that almost exclusively develops in young smokers. Buerger’s disease causes inflammation in arteries and veins, which leads to blockage of these vessels and reduces blood flow to and from the extremities. Decreased blood flow to the arms and legs can lead to development of nonhealing wounds and infection for which some patients may eventually require amputation. Unfortunately, traditional medical and surgical treatments are not effective in Buerger’s disease, so other methods for improving blood flow are needed for these patients. There are several different ways to stimulate new blood vessel formation, both in humans and animal models. The most common treatments involve injection of DNA or viruses that express genes related to blood vessel formation or, alternatively, stem cell–based treatments that help regenerate blood vessels and repair wound tissue. This review explores how safe and effective these various treatments are and describes recent research developments that may lead to better therapies for patients with Buerger’s disease and other vascular disorders.

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Pharmacological treatment for Buerger's disease

Cacione

Macedo

Baptista-Silva

2016

Cochrane Database of Systematic Reviews

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Moderate quality evidence suggests that intravenous iloprost (prostacyclin analogue) is more effective than aspirin for eradicating rest pain and healing ischaemic ulcers in Buerger's disease, but oral iloprost is not more effective than placebo. Verylow and low quality evidence suggests there is no difference between prostacyclin (iloprost and clinprost) and the prostaglandin analogue alprostadil for healing ulcers and relieving pain respectively in severe Buerger's disease. Very-low quality evidence suggests there is no difference in pain scores and amputation rates between folic acid and placebo, in people with Buerger's disease and hyperhomocysteinaemia. High quality trials assessing the effectiveness of pharmacological agents (intravenous or oral) in people with Buerger's disease are needed.

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Landmark Publication from The American Journal of the Medical Sciences: Thrombo-Angiitis Obliterans: A Study of the Vascular Lesions Leading to Presenile Spontaneous Gangrene11Read at a meeting of the Association of American Physicians, Washington, D. C., May 12 and 13, 1908.

Cited by 40 publications

References 0 publications

Buerger’s disease: providing integrated care

Buerger’s disease: providing integrated care

Therapeutic angiogenesis in Buerger’s disease: reviewing the treatment landscape

Pharmacological treatment for Buerger's disease

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Landmark Publication from The American Journal of the Medical Sciences: Thrombo-Angiitis Obliterans: A Study of the Vascular Lesions Leading to Presenile Spontaneous Gangrene11Read at a meeting of the Association of American Physicians, Washington, D. C., May 12 and 13, 1908.

Cited by 40 publications

References 0 publications

Buerger&rsquo;s disease: providing integrated care

Buerger&rsquo;s disease: providing integrated care

Therapeutic angiogenesis in Buerger’s disease: reviewing the treatment landscape

Pharmacological treatment for Buerger's disease

Contact Info

Product

Resources

About

Buerger’s disease: providing integrated care

Buerger’s disease: providing integrated care