Abstract
We have been caring for patients with chronic peripheral artery diseases including thromboangiitis obliterans (TAO) and arteriosclerosis obliterans (ASO). From 1990-1999, 107 patients with chronic peripheral artery disease were admitted to the Department of Anesthesiology in Gunma University Hospital. The number of patients with TAO was 63, among which 15 patients underwent amputation of at least one of their extremities. The number of patients with ASO was 40, among which 15 had amputation. 84% of patients with TAO and 80% of those with ASO had a history of smoking. The smoking rate among patients who had amputation was 100% in the patients with TAO and 92% in those with ASO, respectively. The patients who had amputation had a significantly lower ankle brachial index, serum high density lipoprotein (HDL) concent-ration, and higher total cholesterol/HDL ratio compared to the patients who did not have amputation. Co-existing diseases in the patients included diabetes mellitus, hypertension, ischemic heart disease and brain infarction, regardless of whether or not they had a limb amputated. The medical treatments included anticoagulant drug therapy, vasodilator therapy, sympathetic ganglion block and hyperbaric oxygen therapy. It was suggested that, in order to prevent exacerbation of the disease and to avoid amputation, patients should stop smoking. Also, a strategy to prevent arteriosclerosis should be adopted. A novel therapy, autologous bone marrow transplantation, is considered to be promising as a fundamental therapy.
