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Thromboangiitis Obliterans G005

Last amended 
20 April 2017
Current RMA Instruments
Reasonable Hypothesis SOP
28 of 2017
Balance of Probabilities SOP
29 of 2017
Changes from previous Instruments

SOP Bulletin 196

ICD Coding:
  • ICD-9-CM Codes: 443.1
  • ICD-10-AM Codes: I73.1
Brief description

Thromboangiitis obliterans is a nonatherosclerotic, segmental, inflammatory disease that most commonly affects the small to medium-sized arteries and veins of the extremities, resulting in occlusive thrombus and distal extremity ischaemia.  It occurs almost exclusively in smokers.

Confirming the diagnosis

The diagnosis is predominantly made on clinical grounds. Biopsy of subcutaneous nodules or superficial thrombophlebitis, if present, provides a definitive diagnosis, but is rarely needed.

The relevant medical specialist is a physician or vascular surgeon.

Additional diagnoses covered by SOP
  • Buerger's disease
Clinical onset

 Typical age of onset is 40 to 45 years.  It presents with ischaemia of the hands or feet manifesting as pain and discolouration, and progressing to ulceration.  Superficial thrombophlebitis may be present.

Clinical worsening

Disease progression is usual and amputations are commonly required.  Life expectancy is reduced.  Smoking cessation can reduce symptoms and the risk of major amputations.