Effect of Surgical Sympathectomy in Patients Diagnosed with Thromboangiitis Obliterans Compared to Pharmacotherapy and Bypass Surgery

Background: Thromboangiitis obliterans (TAO) is a vasculopathy involving small and intermediate vessels of extremities with various medical and surgical treatment strategies. Objectives: This cohort study aimed to compare the outcomes of medical and surgical interventions in patients with TAO. Methods: Patients with a definite diagnosis of TAO were enrolled in the study and evaluated on the first day, as well as three and six months follow-up visits. A total of 70 patients with TAO were followed for 30 months. Improvements in the primary complaints (claudication of calves and soles, rest pain, paresthesia, thrombophlebitis migrans, gangrene, scars, Raynaud's phenomenon) were compared between the groups. Results: In terms of gender, 98.6% of participants were male. The mean age of the patients was 43.24 +/- 9.8 years. Based on the results, 37 sympathectomy surgery, 11 amputation surgery, 15 bypass surgery, and 12 medical therapies with ILOPROST were considered for the patients (Medical treatment as combination therapy in patients with severe symptoms). The final results demonstrated that primary complaints were significantly improved in patients who underwent bypass surgery than in others. Conclusion: As evidenced by the obtained results, patients in our study significantly benefited more from bypass surgery than sympathectomy and pharmacotherapy.