A Review of Lower Limb Angiogram in Thrombo Angiitis Obliterans.

Sai Ram, Subramanian (2008) A Review of Lower Limb Angiogram in Thrombo Angiitis Obliterans. Masters thesis, Madras Medical College, Chennai.


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INTRODUCTION : Thromboangiitis obliterans has for long remained a disease difficult to understand due to the various theories ascribed to its pathogenesis and lack of consensus regarding accurate diagnostic criteria. Added to this is the decreasing incidence of the disease in the Japanese population from were important initial contributions to understanding of the diseases came. Thromboangiitis obliterans is a important cause of limb loss and morbidity in our population. Unlike in rest of the world, there has been no respite regarding incidence in our population possibly due to the continued ill effects of beedi smoking. Many patients in our population present with characteristic features of TAO except that they have occlusive disease in the medium and larger sized arteries including the femoral and iliac arteries. The incidence of disease in these proximal vessels seems to be particularly high in our population, contrary to disease definitions elsewhere in the world. The lack of clarity and the importance of the disease has inspired as to conduct this study in order to understand the disease better. AIM : To study angiographic features in patients with critical limb ischemia, satisfying clinical criteria for Thromboangiitis obliterans, with emphasis on: – common vessels involved – site of involvement, and – patterns of disease distribution. CONCLUSION : TAO continues to be a significant source of limb loss and morbidity. Suprageniculate disease affects a significant proportion of patients with TAO in our population. All patients with suprageniculate disease have infrageniculate disease as well. The diagnostic criterion of infrapopliteal disease as mentioned by Shionoya should be an angiographic criterion, and not a clinical criterion. Suprapopliteal vessel disease is more likely to have distal vessels amenable for revascularization. Infrapopliteal vessel disease is unlikely to have suitable distal vessels for revascularization. The disease patterns indicate different pathogenetic mechanisms for initiation and progression of disease at different levels in the arterial tree. This, in turn, could have effects on the probability of revascularization and limb salvage. Further studies are required for accurate understanding of the etiopathology of the disease and to evolve management strategies to reduce limb loss due to TAO.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Lower Limb Angiogram ; Thrombo Angiitis Obliterans ; Review.
Subjects: MEDICAL > Vascular Surgery
Depositing User: Kambaraman B
Date Deposited: 24 Jul 2017 02:21
Last Modified: 24 Jul 2017 02:21
URI: http://repository-tnmgrmu.ac.in/id/eprint/2069

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