Thromboangeitis obliterans in upperlimbs: report of a clinical case

Tromboangeítis obliteranteen extremidades superiores:reporte de un caso clínico

Introduction: Thromboangiitis obliterans (TAO), also known as Buerger’s disease, is
a non-atherosclerotic segmental vasculitis that primarily affects small- and mediumsized arteries and veins in the extremities. It is closely associated with tobacco consumption, which is considered the main risk factor. Although its pathogenesis is not
fully understood, the presence of macrophage and T-cell infiltration in the intraluminal
thrombus has been identified, along with increased expression of adhesion molecules
in the vascular endothelium. Case Description: We present the case of a 45-year-old
male chronic smoker who presented with ischemic pain in the lower extremities and
recurrent episodes of intermittent claudication. Clinical evaluation revealed diminished
distal pulses and trophic changes in the feet. Angiographic studies showed segmental
occlusion of the tibial arteries without evidence of atherosclerosis. A diagnosis of TAO
was established, and smoking cessation was recommended as the primary treatment,
along with vasodilator therapy and revascularization measures. Discussion: The management of TAO is based on smoking cessation, which can prevent disease progression and reduce the risk of amputation. However, in cases of critical ischemia, smoking
cessation alone may be insufficient, necessitating endovascular therapies or bypass
surgery when vascular anatomy allows. Early detection is crucial to prevent irreversible
complications. Conclusions: TAO is an underdiagnosed condition that requires a high
degree of clinical suspicion in young smokers presenting with ischemic symptoms in
the extremities. Smoking cessation remains the most effective intervention to alter the
disease course. Further research is needed to explore new therapeutic strategies to
improve prognosis in advanced cases