vascular thrombus with secondary hemorrhage largely occudes this vessel Image

Also known as thromboangiitis obliterans; due to thrombosis of the vessels of the hands and feet. Etiology remains unknown. CD4+ T cells are predominant in the inflammatory infiltrate in vessels, but CD20, CD31, CD68, adhesion molecules and other inflammatory molecules are also present. Has been linked to the HLA-B54-MICA-1.4 haplotype

Usually occurs in males 20-40 years old who present with pain. Ulceration and gangrene may result. It is basically a diagnosis of exclusion,need to exlude coagulation disorders, lupus, proximal embolic disease. It is strongly associated with tobacco use.

Surgery may be required to restore blood flow. Also streptokinase has been employed. Complete cessation of smoking is essential.

Often reduces life expectancy