Thromboangiitis obliterans

Thromboangitis obliterans - a systemic inflammatory vascular disease with a predominant lesion of the arteries of the muscular type, as well as veins.

Etiology and pathogenesis are unknown. It assumes an allergic reaction to various effects of the external and internal environment of the body. Mostly men are sick at the age of 30 - 45 years.

Symptoms, course. The disease begins gradually with migrating thrombophlebitis, a sense of rapid fatigue and heaviness in the legs, especially in the calf muscles when walking, paresthesias. Later on, intermittent claudication develops, and finally, pain in the limbs, which remains at rest, especially at night. Objectively, there is a decrease in pulsation in the arteries of the lower extremities, and then the pulsation disappears. Early enough, there are trophic disorders on the affected limbs, and then ischemic necrosis. Sometimes the disease acquires the character of a systemic process involving coronary, cerebral, mesenteric arteries with the development of ischemic events, respectively, in the feeding zone of one or another artery. The deterioration of the general condition is noted, the subfebrile state increases the indices of inflammatory activity, in particular, ESR. The course is chronic with exacerbations and remissions, but is steadily progressing, with the aggravation of ischemic events. In the systemic process, it is possible to develop myocardial infarction, ischemic stroke, intestinal necrosis and other diseases that weigh heavily on the prognosis. For diagnostic purposes, arteriography is used.

Treatment. Vasodilators are shown in the form of repeated courses, for example, parmidin (prodektin, anginin) at 0.75-1.5 g per day for 2 months in combination with anticoagulants of direct and indirect action, anti-inflammatory (nonsteroidal) drugs in generally accepted doses, these The agents alternate with angiotrophin or depokallikrein; Novocain blockades, courses of hyperbaric oxygenation (with indications). In systemic forms, corticosteroids and cytotoxic drugs can be a method of choice, but necessarily in combination with anticoagulants and vasodilators.