抄録
Thromboangiitis obliterans, or Buerger's disease, is a comparatively rare but extremely unsettling condition, associated with very high levels of pain, often with amputation or reamputation the only surgical recourse. Because of its propensity to be found in the younger patient, it is important that the most minimal surgery possible is indicated, owing to the possibility of the patient's being forced to lead a life of invalidism following the drastic surgery usually needed in this disease, The authors present three cases seen in their institute, all of which would probably have required amputation, or reamputation, Low reactive-level laser therapy (LLLT) was applied in an outpatient setting. using a 10 mW helium-neon continuous wave laser, at doses ranging from 0.18 and 2.7 J/cm2. Two of the three patients were completely healed, with a one-year follow-up, and the third patient is still undergoing treatment, but with an excellent prognosis, All three patients reported a significant reduction of pain, and demonstrated fast and significant reduction in inflammation and oedema, accompanied by fast and clear demarcation of the necrotic area, and fast granulation of the ulcer's surface, The wounds healed with minimal scarring, Antibiotics had to be used additionally to the LLLT in two of the three reported cases, Infrared thermography was used to evaluate the effect of LLLT on the microvasculature in the affected area, showing on average a 0.9°C increase in temperature. With what is known about the mechanisms of LLLT on the microvasculature, in particular the improvement in blood flow rate, the authors suggest that LLLT provides a noninvasive therapeutic modality for Buerger’s disease, or any other condition related to microvascular impairment. Further studies on the photoautoimmune effects of LLLT are also needed, as there is a strong connection between autoimmunological processes and this condition.
