fetching data ...

THU0435 (2018)
Long-term outcome and prognosis factors of complications in thromboangiitis obliterans (BUERGER’S DISEASE): a multicenter study of 224 patients
A. Le Joncour1, S. Soudet2, A. Dupont3, O. Espitia4, F. Koskas5, P. Cluzel6, P.-Y. Hatron2, P. Cacoub1, M. Resche-Rigon3, M. Lambert2, D. Saadoun1
1Département de médecine interne et immunologie clinique, Hôpital de la Pitié Salpêtrière, Paris
2Département de Médecine Interne et Immunologie Clinique, CHU Lille, Lille
3Département de Biostatistiques, CHU Saint Louis, Paris
4Département de Médecine interne, CHU Hôtel Dieu, Nantes
5Département de chirurgie vasculaire
6Département d’imagerie cardio vasculaire et interventionnelle, Hôpital de la Pitié Salpêtrière, Paris, France

 

Background: Buerger’s disease or thromboangiitis obliterans (TAO) is a non-atherosclerotic arteritis of distal extremities. Data regarding long term outcome of patients with Buerger’s disease or thromboangiitis obliterans (TAO) are lacking and most series come from Middle-East and Far-East.

Objectives: We aim report clinical presentation and assess long-term outcome and prognosis factors in a large cohort of TAO.

Methods: Retrospective multicenter study of characteristics and outcomes of 224 TAO patients fulfilling Papa’s and/or 5 Shinoya’s criterias were analysed. Factors associated with vascular event free survival and amputation free survival were identified.

Results: The median age at diagnosis was 38.532–46 years, 51 (28.5%) patients were female and 81.5% were Caucasians. All but 3 were smokers with a median of 22 pack-year and 22.8% were also addict to cannabis. At diagnosis, 53% had claudication, 73% trophic disorders and 8.8% an infection. Lower extremities and upper extremities were affected in 54% and 28% respectively. Superficial vein thrombosis, Raynaud’s phenomen and arthralgia occurred in 18%, 41% and 8%, respectively.

Ethnic group (non-Caucasian) and ischaemic ulcers or necrosis were independent factors of vascular events HR=7.67 [3.1–19.2] p=0.005 and 2.28 [1.3–4] p<0.001. At 15 years, amputation-free survival and major amputation-free survival were 66% and 91%, respectively. Infection was the only independent predictive factor of amputation HR=4.6[1.9–11], p<0001. Age, sex and cannabis addiction were not associated with events or amputation. Patient who stopped their tobacco consumption had lower vascular event (p=0.029) and amputation rate (p=0.001) than those who continued. Three patients died during follow-up.

Conclusions: This nationwide study shows that 34% of TAO patients will experience an amputation within 15 years from diagnosis. We identified specific characteristics that identified those at highest risk for subsequent vascular complications.

Disclosure of Interest: None declared

DOI: 10.1136/annrheumdis-2018-eular.2317


Citation: Ann Rheum Dis, volume 77, supplement Suppl, year 2018, page A430
Session: Vasculitis