A relatively common chronic occlusive peripheral vascular disease, primarily affecting medium and small arteries in the limbs, with the lower extremities being more frequently involved. It is rare for this condition to occur in blood vessels of the brain, heart, stomach, or intestines.

bubble_chart Diagnosis

1. It is more common in male smokers aged 20 to 40, with the vast majority involving the lower limbs.
2. At onset, the extremities feel cold, numb, and achy, followed by intermittent claudication, eventually progressing to rest pain, especially at night.
3. The skin of the extremities appears purplish-red or pale, with reduced skin temperature, dryness, and calf muscle atrophy. Ulcers or dry gangrene may develop in the toes or feet, accompanied by migratory superficial phlebitis. The dorsalis pedis and/or posterior tibial pulses weaken or disappear. The limb position test is positive, showing pallor when the affected limb is elevated and redness or cyanosis when lowered.
4. Elevated immunoglobulins and positive anti-arterial antibodies aid in diagnosis. Segmental limb pressure measurement, arterial waveform analysis, transcutaneous oxygen pressure measurement, skin temperature assessment, and infrared thermography help determine the location and severity of occlusion. Arteriography reveals segmental distribution of lesions, with narrowing or occlusion in affected segments.

bubble_chart Treatment Measures

Non-surgical therapy

1. General treatment. Strictly prohibit smoking; prevent cold, dampness, and trauma; exercise the affected limb.
2. Drug therapy. Chinese medicine Chinese medicinals, vasodilators, defibrinogenation therapy.
3. Sympathetic nerve block.
4. Limb negative pressure therapy. Place the affected limb in a sealed chamber, applying -10.6 kPa (-80 mmHg) for the upper limb and -13.3 kPa (-100 mmHg) for the lower limb, each session lasting 10–15 minutes, 1–2 times per day, with 10–20 sessions constituting one course of treatment.
5. Hyperbaric oxygen therapy.

1. Thoracic or lumbar sympathectomy. Suitable for early-stage patients.
2. Adrenalectomy. For advanced-stage patients who cannot undergo stirred pulse reconstruction after sympathectomy, adrenalectomy may be performed. The sympathetic ganglia may also be removed simultaneously.
3. Stirred pulse intimal stripping.
4. Stirred pulse bypass surgery.
5. Greater omentum transplantation. Divided into pedicled transplantation and free transplantation, the omentum is sequentially pulled to the distal limb through a subcutaneous tunnel.
6. Limb venous stirred pulse surgery.