What is the treatment for thromboangiitis obliterans?

Thromboangiitis obliterans, referred to as vasculitis, mainly refers to a persistent chronic disease in the surrounding blood vessels and small and medium-sized nerve artery systems. The patient's condition will develop lesions, and severe cases may cause blood clots to cause vascular wall obstruction. This disease is mainly common in the northern region of my country. Severe cases may occur in many young and middle-aged men. As the condition changes, many elderly people will also develop it. For this, everyone should choose the appropriate treatment method to control it.

1. Medication

(1) Dextran-40: Dextran with a molecular weight of 5,000 to 20,000 is administered by intravenous drip. Long-term use may cause bleeding and is not suitable for use in the acute development stage or in ulcer gangrene accompanied by secondary infection.

(2) Vasodilators include tolazoline hydrochloride, niacin, and benzylamine hydrochloride.

(3) Antibiotics: When there is local or systemic infection, choose appropriate antibiotics for treatment.

(4) Glucocorticoids may be considered in the acute phase of the disease, with daily oral prednisone or intravenous hydrocortisone.

(5) Analgesics: Patients with significant pain can choose a variety of analgesics, or use procaine acupuncture injection, intravenous blockade or femoral artery periartery blockade, or even lumbar sympathetic ganglion block or epidural anesthesia.

(6) Local treatment: For dry gangrene, sterile bandage can be used to prevent infection, and for ulcers, Kangfuxin dressing can be applied externally.

2. Surgery

If non-surgical treatment fails, lumbar sympathectomy, great saphenous vein graft bypass or arterial thromboendarterectomy can be performed. When the boundaries of extremity necrosis are limited, the wound is expanded under sterile conditions and the necrotic tissue is removed. For those who have developed finger (toe) gangrene, finger (toe) amputation should be considered.