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Visceral bed involvement in thromboangiitis obliterans: a systematic review

Authors Fakour F, Fazeli B

Received 13 March 2019

Accepted for publication 16 July 2019

Published 15 August 2019 Volume 2019:15 Pages 317—353

DOI https://doi.org/10.2147/VHRM.S182450

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Melinda Thomas

Peer reviewer comments 2

Editor who approved publication: Dr Konstantinos Tziomalos


Faeze Fakour,1 Bahare Fazeli2,3

1Immunology and Microbiology Department, Mashhad Azad University of Medical Sceinces, Mashhad, Iran; 2Immunology Research Center, Inflammation and Inflammatory Diseases Division, Immunology Department, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; 3Vascular Independent Research and Education, European Foundation, Department of Angiology, L.Sacco Hospital, Milan, Italy

Abstract: One of the challenges of thromboangiitis obliterans (TAO) management is in the patients whose other vascular beds are involved and it remains a challenge to know whether to pursue invasive procedures or to continue medical treatment for such TAO patients. The aim of this review was to investigate reports of the involvement of the visceral vessels in TAO and the related clinical manifestations, management approaches and outcomes. According to our systematic review, the frequency of published articles, the organs most commonly involved were the gastrointestinal tract, the heart, the central nervous system, the eye, the kidneys, the urogenital system, the mucocutaneous zones, joints, lymphohematopoietic system and the ear. Notably, reports of the involvement of almost all organs have been made in relation to TAO. There were several reports of TAO presentation in other organs before disease diagnosis, in which the involvement of the extremities presented after visceral involvement. The characteristics of the visceral arteries looked like the arteries of the extremities according to angiography or aortography. Also, in autopsies of TAO patients, the vascular involvement of multiple organs has been noted. Moreover, systemic medical treatment could lead to the recovery of the patient from the onset of visceral TAO. This study reveals that TAO may be a systemic disease and patients should be aware of the possible involvement of other organs along with the attendant warning signs. Also, early systemic medical treatment of such patients may lead to better outcomes and reduce the overall mortality rate.

Keywords: thromboangiitis obliterans, Buerger’s disease, visceral vascular bed, ischemia


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