Thromboangiitis Obliterans

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DURING the past three or four years several new methods for the treatment of thromboangiitis obliterans have been suggested. The most promising have been the anticoagulants, histidine and vitamin C, sympathectomy, tetraethyl ammonium chloride, and caudal anesthesia or lumbar sympathetic block. These, however, should be considered only as supplements to the well-established principles and methods used in the management of thromboangiitis obliterans, namely, elimination of tobacco, careful hygiene and care of the extremities, and proper physical therapy measures.


Following the introduction of heparin and dicumarol as anticoagulants to be employed in the treatment of thromboembolic disease, it was suggested that these preparations might be helpful in thromboangiitis obliterans; Comparatively little coordinated or extensive work has appeared in the literature concerning such use for these anticoagulants. In 1942 Allen et al.1 reported the use of dicumarol in 2 cases, but significant conclusions as to its value could not be drawn. LeFevre2 employed the same substance in 8 cases in 1945 but, noting no definite changes, believed that dicumarol had little effect upon the course of the disease. In 1946 Aggeler3 reported that the anticoagulants had been given in chronic occlusive arterial disease but that their benefits had not yet been determined. Barker4 in 1945 stated that dicumarol was beneficial after acute peripheral arterial thrombosis from any cause and that possibly it might prevent an extending arterial thrombosis such as that present in thromboangiitis obliterans. In 1946 Barker et al.5 reported the treatment of acute arterial occlusion of the extremities with. . .



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