Abstract
Ischemia in TAO involves the upper and lower extremities, caused by infrapopliteal or infrabrachial vaso-occlusive disease. Features of advanced TAO include ischemic ulcerations and digital gangrene. Tobacco is strongly associated with the pathogenesis and progression of TAO, and results in a high degree of social, and financial costs, in addition to chronic morbidity. Smoking cessation is the only fully effective therapy for TAO. Counseling, analgesia, and local wound care are essential components to the management of patients with ischemic ulcers. Reported evidence indicates that intravenous iloprost is an effective pharmacological treatment option for patients with critical limb ischemia (CLI), and may also help heal ulcers and relieve rest pain in patients with TAO. Distal surgical revascularization may obviate amputations and improve quality of life. Emerging research supports a role for endothelin receptor antagonists, immunoadsorption, growth factors, gene and stem cell-based therapies for the treatment of patients with TAO and CLI.
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