Thromboangiitis Obliterans

Overview
  • Thromboangiitis Obliterans is a vasculitis of small and medium-sized arteries which can extend into contiguous veins and nerves. The legs and arms are principally affected, specifically the tibial and radial artery.
Epidemiology
  • Thromboangiitis Obliterans typically occurs in smokers, especially men below the age of 40.
Morphology
  • Thromboangiitis Obliterans is characterized by an initial infiltration of the vascular wall with neutrophils. Over time, the inflammatory infiltrate is replaced with one predominated by mononuclear cells and the occasional granuloma may appear. During the inflammatory period thrombosis of the vascular lumen often occurs, resulting it its occlusion. Over time, vascular fibrosis ensues followed by recanalization of the obstructed vessel.
Clinical Consequences
  • Thromboangiitis Obliterans is characterized by claudication of the extremities which can be highly painful, even at rest, possibly due to inflammatory involvement of adjacent peripheral nerves. Raynaud Phenomenon in the hands and fingers is frequent. Ischemia in extremities can lead to chronic ulcerations of hands and feet and in severe cases gangrenous necrosis.