Doença de Buerger
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Apr 25, 2025
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Resumo
Objetivo: Identificar, na literatura, informações sobre fisiopatologia, manifestações clínicas e intervenções na Doença de Buerger (DE). Métodos: Trata-se de uma revisão integrativa, realizada por meio dos operadores booleanos “(buerger) AND (vascular) AND (physiopathology OR symptoms OR treatment)” e utilizando as plataformas PubMed, Scielo e Lilacs. Os critérios de inclusão foram: artigos completos e disponíveis gratuitamente; artigos em inglês e português; publicados entre 2020-2023. Adotou-se, como critério de exclusão, artigos que não trouxeram conhecimento para o objetivo proposto. Foram utilizados 30 artigos para este estudo. Resultados: A DE, também conhecida como Tromboangeíte Obliterante (TO), exibe um forte componente imunológico (reações endoteliais e radicais livres). As manifestações clínicas incluem dor, palidez, ulcerações, claudicação intermitente e progressão para amputação. A intervenção baseia-se na cessação do cigarro, porém medicamentos podem ser usados, como antiplaquetários e bloqueadores dos canais de cálcio. Intervenções endovasculares percutâneas apresentam boas chances de melhora, entretanto, a revascularização cirúrgica pode não ser viável, a depender do grau de acometimento vascular. Conclusão: A TO é uma vasculite primária de etiologia desconhecida, cuja sintomatologia é secundária ao dano causado pelo estado inflamatório na parede vascular. O tratamento é complexo, amplo, e deve ser individualizado.
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Como Citar
CastroT. J. I. dos S., OliveiraJ. A. de, SantanaB. M. B., BedinP., CruzJ. R. S., FáveroA. J. D. P., DelmondesJ. de M., MeloM. R. N., SantoT. M. do E., & CostaJ. L. (2025). Doença de Buerger. Revista Eletrônica Acervo Saúde, 25, e18630. https://doi.org/10.25248/reas.e18630.2025
Seção
Revisão Bibliográfica
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Referências
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2. AWARA MA, et al. Psychiatric sequelae of thromboangiitis obliterans: a case report and review of the literature. Journal of Medical Case Reports, 2023; 17(40): 1-8.
3. BERGÈRE G, et al. Effect of cannabis consumption on characteristics and evolution of thromboangitis obliterans. European Journal of Vascular Medicine, 2021; 50(4): 301-305.
4. BLUM AG, et al. CT angiography and MRI of hand vascular lesions: technical considerations and spectrum of imaging findings. EDUCATIONAL REVIEW, 2021; 12(16): 1-22.
5. EMMANUEL A, et al. D-dimer levels in patients with thromboangiitis obliterans. THE NATIONAL MEDICAL JOURNAL OF INDIA, 2019; 32(3): 134-136.
6. FAKOUR F, FAZELI B. Visceral bed involvement in thromboangiitis obliterans: a systematic review. Vascular Health and Risk Management, 2019; 15: 317-353.
7. FAZELI B, et al. Angiogenesis induction in Buerger's disease: a disease management doubleedged sword?. Orphanet Journal of Rare Diseases, 2019; 14(198): 1-6.
8. FAZELI B, et al. Detection of Rickettsia Endosymbiont Bemisia Tabaci in the Amputated Limbs of Three Buerger’s Disease Patients. International Medical Case Reports Journal, 2020; 13: 33-40.
9. FAZELI B, et al. Recent Updates and Advances in Winiwarter-Buerger Disease (Thromboangiitis Obliterans): Biomolecular Mechanisms, Diagnostics and Clinical Consequences. Diagnostics, 2021; 11(10): 1-20.
10. GACIONE DC, et al. Pharmacological treatment for Buerger's disease. Cochrane Database Syst Rev, 2020; 5(5): CD011033.
11. GACIONE DC, et al. Stem cell therapy for treatment of thromboangiitis obliterans (Buerger's disease). Cochrane Database of Systematic Reviews, 2018; 2018(10): CD012794.
12. GHONEIM BM, et al. Management of Buerger’s Disease in Endovascular Era. International Journal of Angiology, 2019; 28(3): 173-181.
13. GUPTA PK, et al. Phase IV postmarketing surveillance study shows continued efficacy and safety of Stempeucel in patients with critical limb ischemia due to Buerger's disease. STEM CELLS TRANSLATIONAL MEDICINE, 2021; 10: 1602-1613.
14. HATTA H, et al. Successful lumbal sympathetic block as an alternative therapy for improving Buerger's disease: A rare case report and literature review. International Journal of Surgery Case Reports, 2023; 110: 1-4.
15. JAROONWANICHKUL S, HALL JC. Decreasing tobacco use promotes ulcer healing in a patient with Buerger's disease. Clinical Case Reports, 2023; 11(2): e6999.
16. KACMAZ F, et al. Clinical outcomes of extended endovascular recanalization of 16 consecutive Buerger’s disease patients. Sage Journals, 2019; 27(3): 1-9.
17. KLEIN-WEIGEL P, et al. Buerger’s disease: providing integrated care. Journal of Multidisciplinary Healthcare, 2016; 9: 511-518.
18. KERAMAT S, et al. Assessment of T helper 17-associated cytokines in thromboangiitis obliterans. Journal of Inflammation Research, 2019; 12: 251-258.
19. KOMIYA D, et al. Efficacy of Supervised Exercise Therapy for Intermittent Claudication in a Case With Buerger’s Disease. Cureus, 2023; 15(8): e43537.
20. LI G, et al. Herbal therapy treatment in thromboangiitis obliterans: a retrospective clinical study. Annals of Palliative Medicine, 2020; 9(4): 1696-1707.
21. MERASHLI M, et al. A Meta-Analysis of Plasma Homocysteine in Buerger’s Disease. Thrombosis and Haemostasis, 2022; 122(7): 1243-1246.
22. MISHRA SS, et al. Intestinal thromboangiitis obliterans: a case report. Journal of Medical Case Reports, 2021; 15(215): 1-7.
23. MODAGHEGH M-HS e HAFEZI S. Endovascular Treatment of Thromboangiitis Obliterans (Buerger's Disease). Vascular and Endovascular Surgery, 2018; 52(2): 124-130
24. MOHARERI M, et al. Thromboangiitis obliterans episode: autoimmune flare-up or reinfection?. Vascular Health and Risk Management, 2018; 14: 247-251
25. MONTELIONE N, et al. Duplex and Angiographic-Assisted Evaluation of Outcomes of Endovascular Embolization after Surgical Deep Vein Arterialization for the Treatment No Option Critical Limb Ischemia Patients.
26. PU H, et al. Endovascular Excimer Laser-Assisted Balloon Angioplasty for Infrapopliteal Arteries in Thromboangiitis Obliterans: A Treatment for Acute-Phase TAO. Frontiers in Cardiovascular Medicine, 2022; 9: 1-8.
27. RIBIERAS AJ, et al. Therapeutic angiogenesis in Buerger’s disease: reviewing the treatment landscape. Therapeutic Advances in Rare Disease, 2022; 3: 1-19.
28. SALIMI J, et al. Surgical Treatment Options for Buerger's Disease (Experience with 315 Cases in Iran). Medical Journal of the Islamic Republic of Iran, 2022; 36(1): 1016-1019.
29. SEREFLI D, SAYDAM O. Endovascular treatment of Buerger’s disease in patients with critical limb ischaemia. CARDIOVASCULAR JOURNAL OF AFRICA, 2022; 33(5): 254-259.
30. SHAPOURI-MOGHADAM A, et al. Differences in autoimmunity factors based on the activity of thromboangiitis obliterans. Archives of the Turkish Society of Cardiology, 2021; 49(6): 439-447.
31. SHAPOURI-MOGHADAM A, et al. Para-Clinical and Immunological Evaluation in Buerger's Disease as a Suspected Autoimmune Disease: Case Series. Reports of Biochemistry & Molecular Biology, 2021; 9(4): 379-384.
32. SHIRBAGHAEE Z, et al. Report of a phase 1 clinical trial for safety assessment of human placental mesenchymal stem cells therapy in patients with critical limb ischemia (CLI). Stem Cell Research & Therapy, 2023; 14(174): 1-16.
33. SMITH JA, et al. Off-the-shelf percutaneous deep vein arterialization for no-option chronic limb-threatening ischemia related to Buerger disease. Journal of Vascular Surgery Cases, Innovations and Techniques, 2023; 9(3): 1-6.
34. SOLIMAN M, et al. Thromboangiitis obliterans: Aggressive angioplasty provides a potential solution (randomized pilot study). SAGE Open Medicine, 2020; 8: 1-9.
35. STARACE MVR, et al. Nails Involvement in Winiwarter-Buerger Disease. Skin Appendage Disord, 2022; 8(2): 142-145.
36. SZYDELKO-PASKO U, et al. Evaluation of Choroidal and Retinal Features in Patients with Primary Vasculitis—An Original Optical Coherence Tomography and Optical Coherence Tomography Angiography Study. Journal of Clinical Medicine, 2023; 12(21): 1-13.
37. VIJAYAKUMAR A, et al. Thromboangiitis Obliterans (Buerger’s Disease)—Current Practices. International Journal of Inflammation, 2013; 2013: 1-9.
38. WATANABE Y, et al. Current Trends in Epidemiology and Clinical Features of Thromboangiitis Obliterans in Japan. Circulation Journal, 2020; 84: 1786-1796.
39. WEI Z, et al. The IL-6/STAT3 pathway regulates adhesion molecules and cytoskeleton of endothelial cells in thromboangiitis obliterans. Cellular Signalling, 2018; 44: 118-126.
40. ZIAEEMEHR A, et al. Secondary Infertility: A Neglected Aspect of Buerger’s Disease. Reports of Biochemistry & Molecular Biology, 2022; 11(2): 246-251.
2. AWARA MA, et al. Psychiatric sequelae of thromboangiitis obliterans: a case report and review of the literature. Journal of Medical Case Reports, 2023; 17(40): 1-8.
3. BERGÈRE G, et al. Effect of cannabis consumption on characteristics and evolution of thromboangitis obliterans. European Journal of Vascular Medicine, 2021; 50(4): 301-305.
4. BLUM AG, et al. CT angiography and MRI of hand vascular lesions: technical considerations and spectrum of imaging findings. EDUCATIONAL REVIEW, 2021; 12(16): 1-22.
5. EMMANUEL A, et al. D-dimer levels in patients with thromboangiitis obliterans. THE NATIONAL MEDICAL JOURNAL OF INDIA, 2019; 32(3): 134-136.
6. FAKOUR F, FAZELI B. Visceral bed involvement in thromboangiitis obliterans: a systematic review. Vascular Health and Risk Management, 2019; 15: 317-353.
7. FAZELI B, et al. Angiogenesis induction in Buerger's disease: a disease management doubleedged sword?. Orphanet Journal of Rare Diseases, 2019; 14(198): 1-6.
8. FAZELI B, et al. Detection of Rickettsia Endosymbiont Bemisia Tabaci in the Amputated Limbs of Three Buerger’s Disease Patients. International Medical Case Reports Journal, 2020; 13: 33-40.
9. FAZELI B, et al. Recent Updates and Advances in Winiwarter-Buerger Disease (Thromboangiitis Obliterans): Biomolecular Mechanisms, Diagnostics and Clinical Consequences. Diagnostics, 2021; 11(10): 1-20.
10. GACIONE DC, et al. Pharmacological treatment for Buerger's disease. Cochrane Database Syst Rev, 2020; 5(5): CD011033.
11. GACIONE DC, et al. Stem cell therapy for treatment of thromboangiitis obliterans (Buerger's disease). Cochrane Database of Systematic Reviews, 2018; 2018(10): CD012794.
12. GHONEIM BM, et al. Management of Buerger’s Disease in Endovascular Era. International Journal of Angiology, 2019; 28(3): 173-181.
13. GUPTA PK, et al. Phase IV postmarketing surveillance study shows continued efficacy and safety of Stempeucel in patients with critical limb ischemia due to Buerger's disease. STEM CELLS TRANSLATIONAL MEDICINE, 2021; 10: 1602-1613.
14. HATTA H, et al. Successful lumbal sympathetic block as an alternative therapy for improving Buerger's disease: A rare case report and literature review. International Journal of Surgery Case Reports, 2023; 110: 1-4.
15. JAROONWANICHKUL S, HALL JC. Decreasing tobacco use promotes ulcer healing in a patient with Buerger's disease. Clinical Case Reports, 2023; 11(2): e6999.
16. KACMAZ F, et al. Clinical outcomes of extended endovascular recanalization of 16 consecutive Buerger’s disease patients. Sage Journals, 2019; 27(3): 1-9.
17. KLEIN-WEIGEL P, et al. Buerger’s disease: providing integrated care. Journal of Multidisciplinary Healthcare, 2016; 9: 511-518.
18. KERAMAT S, et al. Assessment of T helper 17-associated cytokines in thromboangiitis obliterans. Journal of Inflammation Research, 2019; 12: 251-258.
19. KOMIYA D, et al. Efficacy of Supervised Exercise Therapy for Intermittent Claudication in a Case With Buerger’s Disease. Cureus, 2023; 15(8): e43537.
20. LI G, et al. Herbal therapy treatment in thromboangiitis obliterans: a retrospective clinical study. Annals of Palliative Medicine, 2020; 9(4): 1696-1707.
21. MERASHLI M, et al. A Meta-Analysis of Plasma Homocysteine in Buerger’s Disease. Thrombosis and Haemostasis, 2022; 122(7): 1243-1246.
22. MISHRA SS, et al. Intestinal thromboangiitis obliterans: a case report. Journal of Medical Case Reports, 2021; 15(215): 1-7.
23. MODAGHEGH M-HS e HAFEZI S. Endovascular Treatment of Thromboangiitis Obliterans (Buerger's Disease). Vascular and Endovascular Surgery, 2018; 52(2): 124-130
24. MOHARERI M, et al. Thromboangiitis obliterans episode: autoimmune flare-up or reinfection?. Vascular Health and Risk Management, 2018; 14: 247-251
25. MONTELIONE N, et al. Duplex and Angiographic-Assisted Evaluation of Outcomes of Endovascular Embolization after Surgical Deep Vein Arterialization for the Treatment No Option Critical Limb Ischemia Patients.
26. PU H, et al. Endovascular Excimer Laser-Assisted Balloon Angioplasty for Infrapopliteal Arteries in Thromboangiitis Obliterans: A Treatment for Acute-Phase TAO. Frontiers in Cardiovascular Medicine, 2022; 9: 1-8.
27. RIBIERAS AJ, et al. Therapeutic angiogenesis in Buerger’s disease: reviewing the treatment landscape. Therapeutic Advances in Rare Disease, 2022; 3: 1-19.
28. SALIMI J, et al. Surgical Treatment Options for Buerger's Disease (Experience with 315 Cases in Iran). Medical Journal of the Islamic Republic of Iran, 2022; 36(1): 1016-1019.
29. SEREFLI D, SAYDAM O. Endovascular treatment of Buerger’s disease in patients with critical limb ischaemia. CARDIOVASCULAR JOURNAL OF AFRICA, 2022; 33(5): 254-259.
30. SHAPOURI-MOGHADAM A, et al. Differences in autoimmunity factors based on the activity of thromboangiitis obliterans. Archives of the Turkish Society of Cardiology, 2021; 49(6): 439-447.
31. SHAPOURI-MOGHADAM A, et al. Para-Clinical and Immunological Evaluation in Buerger's Disease as a Suspected Autoimmune Disease: Case Series. Reports of Biochemistry & Molecular Biology, 2021; 9(4): 379-384.
32. SHIRBAGHAEE Z, et al. Report of a phase 1 clinical trial for safety assessment of human placental mesenchymal stem cells therapy in patients with critical limb ischemia (CLI). Stem Cell Research & Therapy, 2023; 14(174): 1-16.
33. SMITH JA, et al. Off-the-shelf percutaneous deep vein arterialization for no-option chronic limb-threatening ischemia related to Buerger disease. Journal of Vascular Surgery Cases, Innovations and Techniques, 2023; 9(3): 1-6.
34. SOLIMAN M, et al. Thromboangiitis obliterans: Aggressive angioplasty provides a potential solution (randomized pilot study). SAGE Open Medicine, 2020; 8: 1-9.
35. STARACE MVR, et al. Nails Involvement in Winiwarter-Buerger Disease. Skin Appendage Disord, 2022; 8(2): 142-145.
36. SZYDELKO-PASKO U, et al. Evaluation of Choroidal and Retinal Features in Patients with Primary Vasculitis—An Original Optical Coherence Tomography and Optical Coherence Tomography Angiography Study. Journal of Clinical Medicine, 2023; 12(21): 1-13.
37. VIJAYAKUMAR A, et al. Thromboangiitis Obliterans (Buerger’s Disease)—Current Practices. International Journal of Inflammation, 2013; 2013: 1-9.
38. WATANABE Y, et al. Current Trends in Epidemiology and Clinical Features of Thromboangiitis Obliterans in Japan. Circulation Journal, 2020; 84: 1786-1796.
39. WEI Z, et al. The IL-6/STAT3 pathway regulates adhesion molecules and cytoskeleton of endothelial cells in thromboangiitis obliterans. Cellular Signalling, 2018; 44: 118-126.
40. ZIAEEMEHR A, et al. Secondary Infertility: A Neglected Aspect of Buerger’s Disease. Reports of Biochemistry & Molecular Biology, 2022; 11(2): 246-251.