Buerger’s disease: providing integrated care
Peter Klein-Weigel,1 Theresa Sophie Volz,1 Leonora Zange,2 Jutta Richter,3 1Clinic of Angiology, 2Clinic of Cardiology and Nephrology, HELIOS Klinikum Berlin-Buch, Berlin, 3Medical Faculty, Department of Rheumatology and Hiller Research Unit Rheumatology, Heinrich-Heine-University Duesseldorf, Duess...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2016-10-01
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| Series: | Journal of Multidisciplinary Healthcare |
| Subjects: | |
| Online Access: | https://www.dovepress.com/buergerrsquos-disease-providing-integrated-care-peer-reviewed-article-JMDH |
| _version_ | 1819154648069570560 |
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| author | Klein-Weigel P Volz TS Zange L Richter J |
| author_facet | Klein-Weigel P Volz TS Zange L Richter J |
| author_sort | Klein-Weigel P |
| collection | DOAJ |
| description | Peter Klein-Weigel,1 Theresa Sophie Volz,1 Leonora Zange,2 Jutta Richter,3 1Clinic of Angiology, 2Clinic of Cardiology and Nephrology, HELIOS Klinikum Berlin-Buch, Berlin, 3Medical Faculty, Department of Rheumatology and Hiller Research Unit Rheumatology, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany Abstract: 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. Keywords: Winiwater-Buerger's disease, Winiwarter–Buerger, thromboangiitis obliterans, immunoadsorption |
| first_indexed | 2024-12-22T15:24:25Z |
| format | Article |
| id | doaj.art-5f12582433de4c709221559fae3b9fb7 |
| institution | Directory Open Access Journal |
| issn | 1178-2390 |
| language | English |
| last_indexed | 2024-12-22T15:24:25Z |
| publishDate | 2016-10-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Journal of Multidisciplinary Healthcare |
| spelling | doaj.art-5f12582433de4c709221559fae3b9fb72022-12-21T18:21:32ZengDove Medical PressJournal of Multidisciplinary Healthcare1178-23902016-10-01Volume 951151829393Buerger’s disease: providing integrated careKlein-Weigel PVolz TSZange LRichter JPeter Klein-Weigel,1 Theresa Sophie Volz,1 Leonora Zange,2 Jutta Richter,3 1Clinic of Angiology, 2Clinic of Cardiology and Nephrology, HELIOS Klinikum Berlin-Buch, Berlin, 3Medical Faculty, Department of Rheumatology and Hiller Research Unit Rheumatology, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany Abstract: 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. Keywords: Winiwater-Buerger's disease, Winiwarter–Buerger, thromboangiitis obliterans, immunoadsorptionhttps://www.dovepress.com/buergerrsquos-disease-providing-integrated-care-peer-reviewed-article-JMDHBuerger´s diseaseWiniwater-BuergerThrombangiitis obliteransThromboangiitis obliteransImmunoadsorptionIntegrated care |
| spellingShingle | Klein-Weigel P Volz TS Zange L Richter J Buerger’s disease: providing integrated care Journal of Multidisciplinary Healthcare Buerger´s disease Winiwater-Buerger Thrombangiitis obliterans Thromboangiitis obliterans Immunoadsorption Integrated care |
| title | Buerger’s disease: providing integrated care |
| title_full | Buerger’s disease: providing integrated care |
| title_fullStr | Buerger’s disease: providing integrated care |
| title_full_unstemmed | Buerger’s disease: providing integrated care |
| title_short | Buerger’s disease: providing integrated care |
| title_sort | buerger rsquo s disease providing integrated care |
| topic | Buerger´s disease Winiwater-Buerger Thrombangiitis obliterans Thromboangiitis obliterans Immunoadsorption Integrated care |
| url | https://www.dovepress.com/buergerrsquos-disease-providing-integrated-care-peer-reviewed-article-JMDH |
| work_keys_str_mv | AT kleinweigelp buergerrsquosdiseaseprovidingintegratedcare AT volzts buergerrsquosdiseaseprovidingintegratedcare AT zangel buergerrsquosdiseaseprovidingintegratedcare AT richterj buergerrsquosdiseaseprovidingintegratedcare |