Treatment of
thromboangiitis obliterans (Buerger's disease) with high-potency vasodilators
Thromboangiitis obliterans (TAO) or
Buerger's disease is a vascular inflammatory thrombotic occlusive and segmental
disease affecting distal small and medium-sized arteries of the limbs. Tobacco
is the main trigger factor and avoiding it is the main treatment. Frequently,
it is necessary to use high-potency vasodilators, such as iloprost,
bosentan, sildenafil, or alprostadil, to relieve symptoms and reduce the risk
of amputation. Iloprost is the only one that has been shown to be effective in
randomized clinical trials. We report the third case of TAO treated with
sildenafil and a new case treated with bosentan. This condition can be
diagnosed and treated by a dermatologist. We would like to highlight the
excellent clinical response despite the fact that patients continued to smoke.
This finding may have important therapeutic implications because early
treatment may prevent amputation and can be effective even during the process of
giving up smoking.
We are expecting more medical therapies in the coming years to compete with the existing endovascular and surgical therapies.
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