Treatment of Thromboangiitis Obliterans with Rest Pain or Trophic Lesions of the Extremities

In Thromboangiitis obliterans (Buerger's disease), advanced limb ischaemia can manifest as persistent rest pain or progressive tissue loss — including ischemic ulcers and frank gangrene. This clinical presentation demands a prompt, evidence-guided response to preserve limb integrity.

Clinical scenario: A patient with confirmed Thromboangiitis obliterans presenting with rest pain of the extremities, or with trophic lesions — ischemic ulcers or gangrene.

Treatment targets: Healing of trophic lesions and resolution of rest pain over the initial treatment course; complete healing without pain sustained to 24 weeks.

The protocol for this presentation centres on intravenous iloprost therapy delivered over a defined course — the complete dosing protocol, administration schedule, and monitoring criteria are contained in the full structured regimen.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1155/2013/156905

In a randomized study, 152 patients with Buerger's disease presenting with rest pain, with or without trophic changes, received intravenous iloprost or placebo.
After 21–28 days of perfusion, the trophic lesions had healed or the pain had disappeared in 85% of the patients on iloprost and 17% of the patients on aspirin.
A recent study by Bozkurt et al. shows that in intravenous iloprost at dose 1 ng/kg/min the complete healing rate without pain or major amputation was 60.23% at 24 weeks.

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