Abstract

CANNABIS USE: INCREASING RISK OF THROMBOANGIITIS OBLITERANS (BUERGER’S DISEASE)

Siddartha Kaskurthy*, Ashesh Gautam, Sumit Ghimire, Sunil Gyawali, Dilli ram T

ABSTRACT

Thromboangiitis obliterans (TAO) is most commonly associated with tobacco exposure and Cannabis induced from thromboangitis obliterans. It is a non- atherosclerotic inflammatory vasculitis. Which is resulting in small and medium sized arteries and commonly affecting the upper and lower limbs of young men who smoke. The clinical criteria include: age under 45 years; current or recent history of tobacco or cannabis use; Necrosis of the toe, Narrowing of the left tibial–peroneal artery, Involvement of digital arteries, lower limb or juvenile arteriopathies, claudication indicated by distal extremity ischemia presence, pain at rest, gangrenes or ulcers which are documented by non-invasive vascular testing, proximal source of emboli by arterigraphy. Non-involve limbs are the findings of arteriography. The disease is world widely distributed among all patients with peripheral arterial disease is 0.5 to 5.6% in Western Europe countries, 45 to 63% in India, and 16 to 66% in Asia and 80% among Ashkenazi Jews. Initiation inflammatory response resulting in lesions and progression of disease is due to use or exposure to cannabis, but in thromboangiitis obliterans is unknown. It is essential to stop smoking immediately and completely to reduce the incidence of amputation and to prevent in order to prevent progression of disease. And other effective treatments include supportive measures and vasodilating agents or antibiotic, analgesia drugs, surgical revascularization or sympathectomy. Spinal cord stimulation and vascular growth factor gene therapy have is beneficial in alleviating ischemic pain and have been used experimentally in patients with Buerger’s disease with promising results.

Keywords: Thromboangiitis obliterans, arteriopathies, and sympathectomy.