Thromboangiitis obliterans

Abstract

Thromboangiitis obliterans (TAO) was reported in the literature for the fi rst time in 1879 by Felix von Winiwarter [59], who described a vascular syndrome that progressed to gangrene of the lower limb, with extensive thrombosis of the arteries and small veins and preservation of the internal elastic membrane. These pathological fi ndings were in a 57-year-old male patient presenting with foot pain that had begun 12 years earlier, turned into gangrene, and resulted in amputation. Intimal proliferation with thrombosis, fi brosis, and endarteritis different from arteriosclerosis were demonstrated in a pathological specimen. This disease was called endarteritis obliterans until 1908 when Leo Buerger [59] published his classic study of 11 limbs that had been amputated because of ischemia with obstruction of the distal arteries and veins and preservation of entire vascular wall; he called it TAO, reinforcing what had been described by von Winiwater, presenting clinical and pathological differences regarding arteriosclerosis. For his contributions to our understanding of this disease, TAO is also known by the eponym Buerger�s disease. Arteriosclerotic in fl ammatory disease, characterized by the occurrence of thrombotic occlusions, often affects the mediumand small-caliber arteries and veins of the lower and upper limbs, classi fi ed histopathologically as a vasculitis, but differing from most common vasculitises in three important ways © Springer-Verlag London 2013.