Invited Speakers
Kamphol Laohapensang
Nationality
Thailand
Current Position
Professor Emeritus / President
Organization
Thai Vascular Association (TVA)
Peripheral Artery SessionFriday, Oct. 21, 2022 10:30-12:30 @Ballroom I

Topic: Current Status of Diagnosis and Treatment of Buerger's Disease

Abstract

The overall incidence of TAO appears to be decreasing in North America, Western Europe, South Asia, and Japan. A reduction in smoking among the general populations studied and the adoption of stricter diagnostic criteria may explain this decline over the past 4 decades.
A number of studies agree that tobacco use has a strong link to the pathogenesis and progression of TAO. Indeed, the only effective therapy for TAO is complete and permanent discontinuation of smoking. However, various medications, such as vasodilators (calcium channel blockers and prostaglandin analogues), anticoagulants, and thrombolytics, as well as noninvasive treatments, including intermittent pneumatic compression, have shown limited success for decreasing pain and avoiding amputation.
Invasive approaches, such as omental transfer and sympathectomy, have demonstrated promising short-term clinical improvement and low initial amputation rates but limited sustained, long-term symptomatic improvement.
Revascularization is the ideal treatment to reduce ischemic injuries; endovascular or surgical revascularization has often been difficult because of diseased distal runoff and diffuse segmental involvement and thrombotic nature of the disease of TAO. Surgical revascularization is rarely feasible, mainly due to distal arterial and venous involvement, lack of suitable target vessel, and absence of adequate vein conduit. Bypass surgery was carried out for less than 10% of surgically treated patients with TAO.
Since the majority of patients with CLI-are poor candidates for surgical bypass, we offer endovascular revascularization to patients with CLI or rapidly progressive limb-threatening disease, as well as those with recurrent or refractory symptoms who fail conservative management.
Endovascular approaches using various techniques should be considered for effective recanalization if a surgical treatment option is not available in patients with Buerger’s disease. It is also technically challenging because of the diffuse segmental involvement of small distal arteries.

Session

Topic:

Abstract

Education

・MD, FACS, FSVS
・Vascular Surgery Fellowship, University of Colorado, USA

Research Experience

・Burger’s disease in Northern part of Thailand
・Vascular pythiosis in thalassemic patients
・Management of the Infected Aortoiliac Aneurysms
・Management of the infected aortic endograft

Honors/Awards

・TVA Lifetime Achievement Awards

Selected Publications
  • Seasonal variation of Burger’s disease in Northern part of Thailand. Eur J Vasc Endovasc Surg 2004; 8:418-420.
  • Decrease in Recurrence of Buerger’s disease in Northern part of Thailand. Surg Today2005; 35(12): 1060-1065.
  • Vascular pythiosis in thalassemic patients. Vascular 2009:17(4): 234-8.
  • Management of the Infected Aortoiliac Aneurysms. Annals of Vascular Disease 2012: 5(3): 1-8.
  • Management of the infected aortic endograft. Seminars in Vascular Surgery 2017; 30: 91-94.
  • A Para-renal Abdominal Aortic Aneurysm with Iliac arteries stenosis. J Vasc Surg 2018; 4:106-7.
  • Aorto-enteric Fistula After Endovascular Abdominal Aortic Aneurysm Repair for Behcet’s Disease Patient. European Journal of Vascular and Endovascular Surgery 2018: 39:54-57.
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