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Brief Introduction:

It is also known as “thromboangiitis obliterans”. It is a vasculities of small and medium-size

veins and arteries of young adults. It is characterized by recurring inflammation of the intermediate and
small arteries and veins of the lower and (in rare cases) upper extremities. The disease process starts
distally and progresses cephalad, involving both upper and lower extremities. It usually occurs in males
who are 25-40 years old due to heavy smoking which causes vasoconstriction thereby interrupting of
decreasing the blood flow to the parts of the body and it also affects the immune response which may
work exaggerately. However, it is can also occur in females as to the report of increasing frequency of
young female smokers. Obesity may that may lead to atherosclerosis.

Signs and symptoms:

 Pain- it is the most outstanding symptom - due to intermittent claudication.

 Rest pain with persistent ischemia of 1 or more digits - due to occlusion of decreases blood flow.

 Paresthesia – due to diminished nerve sensation.

 Finger’s and toes turn pale when exposed to cold (Raynaud’s phenomenon) – due to decreased
blood flow as affected by cold temperature.

 Absent or weak tibial pulse

 Cyanosis - ( cyanosis bluish discoloration of the skin and mucous membrane due to lack
of oxygen in the blood) a later manifestation.

 Ulcerations and gangrene – if there is prolonged insufficient blood supply.


 Arteriography - may indicate a proximal source of emboli. It is the most conclusive diagnostic
procedure for peripheral vascular diseases.

 Ultrasound - may indicate presence of distal extremity ischemia (indicated by claudication, pain
at rest, ischemic ulcers or gangrene).

Medical Management:

 Low cholesterol diet

 Low salt diet
 Physical exercise
 Drug Thrapy -Prostaglandins – Prostaglandin I2 (ilioprost) has antiplatelet and
vasodilator activity.
(b) Dextran –It Cause hemodilution, decrease
blood viscosity and improve microcirculation.
(c) Praxiline (Niftidrofuryloxalate) – It alter tissue metabolism, increase claudication
distance by allowing a greater O2 supply to tissue no proved benefit.
(d) Trental (oxypentifylline) – It has effect on whole blood viscosity by reducing it.
 Physiotherapy
 Amputation - if any gangrene
 Vascular surgery

Nursing Mangemengent:

 assessing for pain – to monitor if it being tolerated or needs medication to relieve pain.
 obtaining blood pressure – serves as a baseline data for peripheral pulse
 assessing for signs of ulcer formation
 assessing for signs of gangrene

 Quit smoking – to prevent further occlusion of the blood vessels

 Foot care – to decrease the occurrence of infection and gangrene.

 protect from trauma to avoid source of infection

 enough rest

 increase fluid intake

 socks or stocking must always clean

 slight massage of the food with moisturizer

 avoid circular or rolled stocking