Dtsch Med Wochenschr 2015; 140(20): 1486-1489
DOI: 10.1055/s-0041-106246
Klinischer Fortschritt
Angiologie
© Georg Thieme Verlag KG Stuttgart · New York

Thromboangiitis obliterans (Morbus Winiwater-Buerger)

Update 2015Thromboangiitis obliterans (Buergerʼs disease): update 2015
Peter Klein-Weigel
1   Klinik für Angiologie, HELIOS Klinikum Berlin-Buch, Berlin
,
Theresa Sophie Volz
1   Klinik für Angiologie, HELIOS Klinikum Berlin-Buch, Berlin
,
Jutta Richter
2   Poliklinik, Funktionsbereich & Hiller Forschungszentrum für Rheumatologie, Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität, Düsseldorf
› Author Affiliations
Further Information

Publication History

Publication Date:
07 October 2015 (online)

Zusammenfassung

Die Thromboangiitis obliterans ist eine Vaskulitis mit undulierendem klinischen Verlauf und multisegmentalem Befall der kleinen und mittleren Arterien und Venen, die zu zellreichen thrombotischen Verschlüssen führt. Die Erkrankung ist an einen Tabakkonsum gebunden. Zunehmende Erkenntnisse über die Bedeutung immunologischer Mechanismen in der komplexen Pathophysiologie der Erkrankung kumulierten in der Formulierung einer neuen Autoimmunhypothese als neues Paradigma. Neue Behandlungskonzepte umfassen die Progenitorzellltherapie, die Immunadsorption, die Endothelin-Rezeptorblockade mit Bosentan und den Einsatz von Phosphodiesterase V-Inhibitoren.

Abstract

Thromboangiitis obliterans (Buergerʼs disease) is a vasculitis with undulating clinical course multisegmentarily affecting small and medium-sized arteries and veins. The disease is closely linked to tobacco-use. Increasing knowledge of autoimmunologic mechanisms in the complex pathophyiology of the disease let to the formulation of an autoimmunity-hypothesis now serving as a new paradigma. New treatment options comprise progenitor-cell-therapy, immunoadsorption, use of sendothelin-receptor-blocking agent Bosentan, and prescriptions of antiphosphodiesterase-V-inhibitors.

 
  • Literatur

  • 1 Buerger L. Landmark publication from the American Journal of the Medical Sciences, ‚Thrombo-angiitis obliterans: a study of the vascular lesions leading to presenile spontaneous gangrene‘. 1908. Am J Med Sci 2009; 337: 274-284
  • 2 Dargon PT, Landry GJ. Buergerʼs disease. Ann Vasc Surg 2012; 26: 871-80
  • 3 Arkkila PE. Thrombangiitis obliterans (Buergerʼs disease). Orphanet J Rare Dis 2006; 1: 14
  • 4 Olin JW, Young JR, Graor RA et al. The changing clinical spectrum of thromboangiitis obliterans (Buerger‘s disease). Circulation 1990; 825 (Suppl): IV3-8
  • 5 Fazeli B. Buergerʼs disease as an indicator of socioeconomic development in different societies, a cross-sectional descriptive study in the North-East of Iran. Arch Med Sci 2010; 6: 343-347
  • 6 Sasaki S, Sakuma M, Kunihara T, Yasuda K. Current trends in thromboangiitis obliterans (Buergerʼs disease) in women. Am J Surg 1999; 177: 316-320
  • 7 Kobayashi M, Ito M, Nakagawa A et al. Immunohistochemical analysis of arterial wall cellular infiltration in Buergerʼs disease (endarteritis obliterans). J Vasc Surg 1999; 29: 451-458
  • 8 Lee T, Seo JW, Sumpio BE et al. Immunobiologic analysis of arterial tissue in Buergerʼs disease. Eur J Vasc Endovasc Surg 2003; 25: 451-457
  • 9 Kim EJ, Cho BS, Lee TS et al. Morphologic change of the internal elastic lamina in buergerʼs disease. J Korean Med Sci 2000; 15: 44-48
  • 10 Dellalibera-Joviliano R, Joviliano EE, Silva JS, Evora PR. Activation of cytokines corroborate with development of inflammation and autoimmunity in thromboangiitis obliterans patients. Clin Exp Immunol 2012; 170: 28-35
  • 11 Slavov ES, Stanilova SA, Petkov DP, Dobreva ZG. Cytokine production in thromboangiitis obliterans patients: new evidence for an immune-mediated inflammatory disorder. Clin Exp Rheumatol 2005; 23: 219-226
  • 12 Klein-Weigel PF, Richter JG. Thromboangiitis obliterans (Buergerʼs disease). VASA 2014; 43: 337-346
  • 13 Klein-Weigel PF, Bimmler M, Hempel P et al. G-protein coupled receptor auto-antibodies in thromboangiitis obliterans (Buergerʼs disease) and their removal by immunoadsorption. Vasa 2014; 43: 347-52
  • 14 Ketha SS, Cooper LT. The role of autoimmunity in thromboangiitis obliterans (Buergerʼs disease). Ann N Y Acad Sci 2013; 1285: 15-25
  • 15 Shinoya S. Diagnostic criteria of Buergerʼs disease. Int J Cardiol 1988; 66 (Suppl. 01) S243-245
  • 16 Fazeli B, Modaghegh H, Ravrai H et al. Thrombophlebitis migrans as a footprint of Buergerʼs disease. Clin Rheumatol 2008; 27: 55-57
  • 17 Hackl G, Milosavljevic R, Belaj K et al. The value of FDG-PET in the diagnosis of thromboangiitis obliterans. Clin Rheumatol 2015; 34: 739-44105
  • 18 Börner C, Heidrich H. Long-term follow-up of thrombangiitis obliterans. Vasa 1998; 27: 80-86
  • 19 Cooper LT, Henderson SS, Ballman KV et al. A prospective, case-control study of tobacco dependence in thromboangiitis obliterans (Buergerʼs Disease). Angiology 2006; 57: 73-78
  • 20 Fiessinger JN, Schäfer M. Trial of iloprost versus aspirin treatment for critical limb ischaemia of thromboangiitis obliterans. The TAO Study. Lancet 1990; 335: 555-557
  • 21 Bozkurt AK, Köksal C, Demirbas MY et al. Turkish Buerger‘s Disease Research Group. A randomized trial of intravenous iloprost (a stable prostacyclin analogue) versus lumbar sympathectomy in the management of Buergerʼs disease. Int Angiol 2006; 25: 162-168
  • 22 Bozkurt AK, Cengiz K, Arslan C et al. A stable prostacyclin analogue (iloprost) in the treatment of Buergerʼs disease. Ann Thorac Cardiovasc Surg 2013; 19: 120-125
  • 23 Donas KP, Schulte S, Ktenidis K, Horsch S. The role of epidural spinal cord stimulation in the treatment of Buergerʼs disease. J Vasc Surg 2005; 41: 830-836
  • 24 Vaquer Quiles L, Blasco González L, Asensio Samper J et al. Epidural neurostimulation of posterior funiculi for the treatment of Buergerʼs disease. Neuromodulation 2009; 12: 156-160
  • 25 Graziani L, Morelli L, Parini F et al. Clinical outcome after extended endovascular recanalization in Buergerʼs disease in 20 consecutive cases. Ann Vasc Surg 2012; 26: 387-395
  • 26 Yuan L, Bao J, Zhao Z et al. Clinical results of percutaneous transluminal angioplasty for thromboangiitis obliterans in arteries above the knee. Atherosclerosis 2014; 235: 110-115109
  • 27 Lawall H, Bramlage P, Amann B. Treatment of peripheral arterial disease using stem and progenitor cell therapy. J Vasc Surg 2011; 53: 445-453
  • 28 Lee KB, Kang ES, Kim AK et al. Stem cell therapy in patients with thromboangiitis obliterans: assessment of the long-term clinical outcome and analysis of the prognostic factors. Int J Stem Cells 2011; 4: 88-98
  • 29 Baumann G, Stangl V, Klein-Weigel P et al. Successful treatment of thromboangiitis obliterans (Buergerʼs disease) with immunoadsorption. Clin Res Cardiol 2011; 100: 683-690
  • 30 Klein-Weigel P, Köning C, Härtwig A et al. Immunadsorption bei Thrombangiitis obliterans – eine vielversprechende therapeutische Option. Zentralbl Chir 2012; 137: 460-465
  • 31 Fazeli B, Rafatpanah H, Ravari H et al. Sera of patients with thromboangiitis obliterans activated cultured human umbilical vein endothelial cells (HUVECs) and changed their adhesive properties. Int J Rheum Dis 2014; 17: 106-112
  • 32 Todoli Parra JA, Hernández MM, Arrébola López MA. Efficacy of bosentan in digital ischemic ulcers. Ann Vasc Surg 2010; 24: 690
  • 33 De Haro J, Acin F, Bleda S et al. Treatment of thromboangiitis obliterans (Buergerʼs disease) with bosentan. BMC Cardiovasc Disord 2012; 12: 15
  • 34 De Haro J, Bleda S, Acin F. An open-label study on long-term outcomes of bosentan for treating ulcers in thromboangiitis obliterans (Buergerʼs disease). Int J Cardiol 2014; 177: 529-531
  • 35 Jiménez-Gallo D, Albarrán-Planelles C, Arjona-Aguilera C et al. Treatment of thromboangiitis obliterans(Buergerʼs disease) with high-potency vasodilators. Dermatol Ther 2015; 28: 135-139