What are the stages of thromboangiitis obliterans?

Thromboangiitis obliterans is a common disease in daily life. It is characterized by insidious onset, slow progression, and periodic attacks. It poses a huge threat to human health. Therefore, understanding the staging symptoms of thromboangiitis obliterans is very helpful for treatment.

Stage I: There are no obvious clinical symptoms in the affected limb, or only numbness and coldness. Examination reveals that the skin temperature of the affected limb is low, the color is pale, and the pulsation of the dorsalis pedis and (or) posterior tibial artery is weakened; the ankle/brachial index is <0.9. There is localized arterial stenosis in the affected limb.

Stage II: The main symptom is intermittent claudication after movement of the affected limb. According to the maximum intermittent claudication distance in which pain occurs after walking, it is divided into: Ⅱa>200m; Ⅱb<200m. The skin temperature of the affected limb decreases and the color becomes paler. Dry skin, desquamation, deformed toenails, and calf muscle atrophy may occur. The dorsalis pedis and/or posterior tibial artery pulses disappear. The degree and range of lower limb artery stenosis are more serious than stage I, and the limbs rely on collateral compensation to remain alive.

Stage III: Ischemic rest pain is the main symptom. The pain is severe and continuous, especially at night, forcing the patient to sit with his knees bent and his feet protected, toss and turn, or to let his limbs hang down in an attempt to relieve the pain. In addition to the aggravation of all symptoms in stage II, the toe (fingertip) base becomes dark red, and may be accompanied by edema of the distal limb. The arteries have extensive and severe stenosis, the collateral circulation can no longer compensate for the resting blood supply, and the tissue is on the verge of necrosis.

Stage IV: Symptoms continue to worsen. In addition to resting pain, the affected limbs also develop blackening and shriveling of the toe (fingertip) tips, gangrene, or ischemic ulcers. If secondary infection occurs, dry gangrene will turn into wet gangrene, and symptoms of systemic toxic blood such as fever and irritability will appear. The diseased artery is completely occluded, and the ankle/brachial index is <0.3. The blood flow provided by the collateral circulation can no longer maintain tissue survival.