School of Medicine, Division of Inflammation and Inflammatory Diseases, Immunology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Slovenia Academic Research Center, Slovenian Medical Academy, Medical Association of Slovenia and SMA, Ljubljana, Slovenia -
Int Angiol. 2021 Oct;40(5):395-408. doi: 10.23736/S0392-9590.21.04712-X. Epub 2021 Jul 8.
Even today thromboangiitis obliterans has disease features that remain misunderstood or underappreciated. The epidemiology, etiology and pathophysiology of the disease are still unclear. Biomarkers and disease activity markers are lacking, thus clinical assessment is difficult. We are still struggling to establish unique diagnostic, staging and treatment criteria. This is an academic-collaborative effort to describe the pathophysiology, the clinical manifestations, the diagnostic approach, and the challenges of management of patients with TAO. A systematic search for relevant studies dating from 1900 to the end of 2020 was performed on the PubMed, SCOPUS, and Science Direct databases. Given the intriguing nature of presentation of TAO, its management, to some extent is not only different in different regions of the world but also varies within the same region. Following this project, we discovered ambiguity, overlap and lack of clear-cut criteria for management of TAO. An international group of experts however came to one conclusion. They all agree that management of TAO needs a call for action for a renewed global look with multi-center studies, to update the geographical distribution of the disease and to establish a unique set of diagnostic criteria and a consensus-based guideline for best treatment based on current evidence.
即使在今天，血栓闭塞性脉管炎仍然存在一些人们尚未完全理解或重视的疾病特征。该病的流行病学、病因学和病理生理学仍不清楚，缺乏生物标志物和疾病活动标志物，因此临床评估较为困难。我们仍在努力建立独特的诊断、分期和治疗标准。这是一项学术合作努力，旨在描述血栓闭塞性脉管炎的病理生理学、临床表现、诊断方法以及患者管理的挑战。对 PubMed、SCOPUS 和 Science Direct 数据库中从 1900 年到 2020 年底的相关研究进行了系统检索。鉴于血栓闭塞性脉管炎的表现颇具吸引力，其管理在一定程度上不仅在世界不同地区有所不同，而且在同一地区也存在差异。通过这个项目，我们发现了管理血栓闭塞性脉管炎的标准存在模糊性、重叠性和缺乏明确性。然而，一个国际专家组得出了一个结论。他们都认为，血栓闭塞性脉管炎的管理需要采取行动，呼吁进行全球范围的重新审视，开展多中心研究，更新疾病的地理分布，并根据现有证据建立一套独特的诊断标准和基于共识的最佳治疗指南。
