Treatment Options for Buerger Disease: A Systematic Review and Meta-Analysis of Outcomes

IF 1.7 3区医学 Q2 SURGERY Journal of Surgical Research Pub Date : 2025-02-01 DOI:10.1016/j.jss.2024.12.034

Ramin Shekouhi MD , Mohammed Mumtaz BS , Humza Naqvi MHS , Armina Azizi MD , Kristina M. Crawford DO , Benjamin N. Jacobs MD , Harvey Chim MD

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Abstract

Introduction

Uncertainties exist regarding the optimal management strategy for patients with thromboangiitis obliterans (TAOs). The aim of this study was to investigate the safety and effectiveness of common interventions used for treating patients with TAO.

Methods

Endovascular treatment, revascularization, sympathectomy, stem cell therapy (SCT), and nonsurgical interventions were selected for inclusion in the study. Changes in mean visual analogue scale score and ankle brachial index (ABI) values were evaluated. In addition, the rate of ulcer healing, postintervention amputation, and overall complication rates were compared across interventions.

Results

A total of 1262 TAO patients (1159 males, 84 females), with a mean age of 38.4 ± 7.8 ys, were included in this systematic review. With an amputation rate of 16.6%, the endovascular treatment group showed statistically significant improvements in mean ABI and visual analogue scale scores (P < 0.05). There was a greater increase in ABI postoperatively with endovascular treatment compared to SCT (P < 0.05), and also a greater increase in ABI postoperatively with revascularization compared to SCT (P < 0.05). Meta-regression showed that both endovascular treatment and open surgical revascularization were superior to stem cell treatment for postoperative mean ABI improvement (P < 0.05). Interestingly, the rate of postoperative amputation was lower in the SCT group compared with the other two interventions.

Conclusions

Our results indicated that all three interventions may be a reasonable therapeutic option for TAO. Endovascular intervention and open revascularization demonstrated superior outcomes.

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伯格氏病的治疗选择：结果的系统回顾和荟萃分析。

摘要：血栓闭塞性脉管炎（TAOs）患者的最佳治疗策略存在不确定性。本研究的目的是探讨用于治疗TAO患者的常用干预措施的安全性和有效性。方法：选择血管内治疗、血管重建术、交感神经切除术、干细胞治疗（SCT）和非手术干预措施纳入研究。评估平均视觉模拟量表评分和踝肱指数（ABI）值的变化。此外，还比较了不同干预措施的溃疡愈合率、干预后截肢率和总并发症率。结果：本系统综述共纳入TAO患者1262例（男性1159例，女性84例），平均年龄38.4±7.8岁。在截肢率为16.6%的情况下，血管内治疗组在平均ABI和视觉模拟量表评分上有统计学意义的改善(P)。结论：我们的研究结果表明，这三种干预措施可能是TAO的合理治疗选择。血管内介入和开放血运重建术显示出优越的结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Surgical Research 医学-外科

CiteScore

3.90

自引率

4.50%

发文量

627

审稿时长

138 days

期刊介绍： The Journal of Surgical Research: Clinical and Laboratory Investigation publishes original articles concerned with clinical and laboratory investigations relevant to surgical practice and teaching. The journal emphasizes reports of clinical investigations or fundamental research bearing directly on surgical management that will be of general interest to a broad range of surgeons and surgical researchers. The articles presented need not have been the products of surgeons or of surgical laboratories. The Journal of Surgical Research also features review articles and special articles relating to educational, research, or social issues of interest to the academic surgical community.