1. How to Treat a Patient with Thromboangiitis Obliterans: A Systematic Review.
- Author
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Fazeli B, Dadgar Moghadam M, and Niroumand S
- Subjects
- Adult, Amputation, Surgical, Cardiovascular Agents adverse effects, Humans, Limb Salvage adverse effects, Middle Aged, Risk Factors, Thromboangiitis Obliterans diagnosis, Thromboangiitis Obliterans surgery, Treatment Outcome, Vascular Surgical Procedures adverse effects, Cardiovascular Agents therapeutic use, Limb Salvage methods, Spinal Cord Stimulation adverse effects, Stem Cell Transplantation adverse effects, Sympathectomy adverse effects, Thromboangiitis Obliterans therapy, Vascular Surgical Procedures methods
- Abstract
To date, there is still no treatment protocol for patients with thromboangiitis obliterans (TAO) who are also afflicted with critical limb ischemia (CLI). Smoking cessation on its own cannot be considered a treatment for the purposes of salvaging a limb of a TAO patient with CLI. The aim of this review was to evaluate different studies of various treatment protocols for avoiding amputation in TAO patients. A systematic search for relevant studies dating from 1990 to the end of 2016 was performed on the PubMed, SCOPUS, and Science Direct databases. Only 24 studies fulfilled the inclusion criteria, of which only one was a randomized controlled trial (RCT). The remaining studies were quasi-experimental with various treatments and follow-up durations. Therefore, meta-analysis was not performed. Judging from the major amputation rates after the suggested treatments were performed, no treatment was particularly effective. This review demonstrated that more standard RCTs are needed to resolve this treatment issue involved in TAO. In addition, because health insurance coverage for TAO patients differs by country, regional cost-benefit and cost-efficacy studies of the suggested treatments for TAO are highly recommended., (Copyright © 2018 Elsevier Inc. All rights reserved.)
- Published
- 2018
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