Thromboangiitis Obliterans involves 3 phases: acute, sub-acute, and chronic.
CLINICAL PRESENTATION: Patients with Thromboangiitis Obliterans typically present with ischemic symptoms caused by stenosis or occlusion of the distal small arteries and veins.
Arterial occlusive disease resulting from Thromboangiitis Obliterans often presents as intermittent claudication of the feet, legs, hands, or arms.
Superficial thrombophlebitis differentiates Thromboangiitis Obliterans from other vasculatures and atherosclerosis, although it may also be observed in Behcet's disease.
The physical examination of a patient with suspected Thromboangiitis Obliterans includes a detailed vascular examination with palpation of peripheral pulses, auscultation for arterial bruits, and measurement of ankle: brachial pressure indices.
DIAGNOSIS: Thromboangiitis Obliterans is a clinical diagnosis that requires a compatible history, supportive physical findings, and diagnostic vascular abnormalities on imaging studies.
Laboratory testing in patients with suspected Thromboangiitis Obliterans is used to exclude alternative diagnoses.
Lupus anticoagulant and anticardiolipin antibodies are detected in some patients with Thromboangiitis Obliterans but may also indicate an isolated thrombophilia.
Distal small- to medium-artery involvement, segmental occlusions, and "corkscrew"-shaped collaterals around areas of occlusion are typical angiographic findings in Thromboangiitis Obliterans.