Treatment of thromboangiitis obliterans (Buerger's disease) with high-potency vasodilators

Dermatol Ther. 2015 May-Jun;28(3):135-9. doi: 10.1111/dth.12207. Epub 2015 Feb 3.

Abstract

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.

Keywords: Buerger's disease; bosentan; sildenafil; thromboangiitis obliterans.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Bosentan
  • Hand / blood supply*
  • Humans
  • Male
  • Middle Aged
  • Remission Induction
  • Sildenafil Citrate / therapeutic use*
  • Sulfonamides / therapeutic use*
  • Thromboangiitis Obliterans / diagnosis
  • Thromboangiitis Obliterans / drug therapy*
  • Thromboangiitis Obliterans / physiopathology
  • Treatment Outcome
  • Vasodilation / drug effects*
  • Vasodilator Agents / therapeutic use*

Substances

  • Sulfonamides
  • Vasodilator Agents
  • Sildenafil Citrate
  • Bosentan