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Int J Angiol
DOI: 10.1055/s-0044-1788627
Case Report

Intra-Arterial Nitroglycerin Injection in Upper Extremity Buerger's Disease for Faster Ulcer Recovery: A Case Report

Nyityasmono Tri Nugroho 
1   Division for Vascular and Endovascular Surgery, Department of Surgery, Faculty of Medicine, Universitas Indonesia – Cipto Mangunkusumo National Hospital, Jakarta, Indonesia
2   Department of Surgery, Faculty of Medicine, Universitas Indonesia – University of Indonesia Hospital, Depok, Indonesia
,
Raka Aldy Nugraha
2   Department of Surgery, Faculty of Medicine, Universitas Indonesia – University of Indonesia Hospital, Depok, Indonesia
,
R. Mohamad Javier
1   Division for Vascular and Endovascular Surgery, Department of Surgery, Faculty of Medicine, Universitas Indonesia – Cipto Mangunkusumo National Hospital, Jakarta, Indonesia
,
Alexander Jayadi Utama
1   Division for Vascular and Endovascular Surgery, Department of Surgery, Faculty of Medicine, Universitas Indonesia – Cipto Mangunkusumo National Hospital, Jakarta, Indonesia
,
Dedy Pratama
1   Division for Vascular and Endovascular Surgery, Department of Surgery, Faculty of Medicine, Universitas Indonesia – Cipto Mangunkusumo National Hospital, Jakarta, Indonesia
› Author Affiliations Funding None.
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Abstract

Thromboangiitis obliterans (TAO), also known as Buerger's disease, is a challenging nonatherosclerotic vascular disorder predominantly affecting smokers. Current management of TAO lacks standard guidelines, with smoking cessation as the only cornerstone. We present the case of a 28-year-old smoker with TAO manifesting as necrotic finger ulcers. Regardless of initial debridement, conventional therapy failed to improve his condition. Angiography confirmed the diagnosis of TAO and intra-arterial nitroglycerin injection was administered, leading to immediate vasodilation and improved perfusion. Combined with oral vasodilators and anticoagulants, the patient showed significant ulcer healing within 2 weeks. TAO's etiology remains unclear; however, it is linked to smoking and immune responses. Diagnosis relies on clinical criteria and angiographic findings. While smoking cessation remains crucial, various pharmacological interventions like vasodilators show considerable potential for enhancing therapeutic outcomes. Our case highlights the potential of intra-arterial nitroglycerin in TAO management. However, further studies are warranted due to limited sample size. Advancements in understanding TAO's biology and diagnostic techniques offer hope for improved management strategies in the future.

Keywords

thromboangiitis obliterans - Buerger's disease - smoking - angiography - intra-arterial - nitroglycerin - vasodilator


Publication History

Article published online:
22 July 2024

© 2024. International College of Angiology. This article is published by Thieme.

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