Vaskulárna medicína 1/2022

Thromboangiitis obliterans and smoking – more questions than answers

Thromboangiitis obliterans (TAO) is a nonatherosclerotic, segmental, inflammatory vessel disease that is strongly associated with smoking and commonly affects the small- and medium-sized arteries of the lower and upper extremities, but rarely also the coronary, cerebral, pulmonary, renal and mesenteric arteries. TAO is a vasculitis which is completely different from every other type of systemic vasculitis. Smoking is central to the initiation and continuance of Winiwarter-Buerger´s disease activity. To cease the smoking is still the most important therapeutic procedure. The trigger for inflammatory – thrombotic events in TAO is unknown as well as it is still not known why from many million smokers all around the world, only a very few of them will develop TAO. Despite quite extensive literature which has been accumulated around this disease, specific diagnostic criteria and therapy remains unknown. The diagnosis is usually based on elimination of atherosclerosis and other types of vasculitis. TAO is quite a rare disease, but it begins in young people and often leads to disability and therefore presents a serious medical and social problem. It is very difficult to study rare diseases such as TAO, therefore there is only a little progress in understanding the etiology and pathogenesis of the disease as well as treatment possibilities.

Keywords: thromboangiitis obliterans, smoking, diagnostic criteria, therapy