Thromboangiitis obliterans: a review

Abstract

Buerger's disease was initially described by von Winiwarter in 1879 where he described it as thromboangiitis obliterans (TAO), detailing the case of spontaneous gangrene secondary to intimal proliferation. In 1908, Leo Buerger published a complete pathological description based on the amputation of a group of people who later suffered short-term gangrene. Buerger's disease or TAO is defined as a non-atherosclerotic inflammatory vasculitis that affects the small and medium vessels (including arteries and veins) of the lower and upper extremities. Although there are hypotheses about its etiopathogenesis such as the association with exposure to tobacco, few biomedical investigations have been carried out, so its direct causality remains unknown. Diagnosis continues to be a challenge, since the findings tend to be non-specific or inconsistent with suspicion, which is why it is currently based on ruling out other causes such as atherosclerosis and vasculopathies. With current evidence, there are many types of treatments, both pharmacological and non-pharmacological, with the cessation of tobacco consumption having greater evidence of results. It is essential to strengthen basic research as well as clinical trials to standardize management in this type of patient, since it is a disease with a high impact on quality of life.