[Arteriopathies of the lower limbs in adults under 40 years of age]

In Morocco, thromboangiitis obliterans (TAO) is the most common cause of obliterating arteriopathy in subjects under 40 years: 252 cases out of 291, versus 21 cases of diabetic arteritis and 18 miscellaneous causes. The anatomo-clinical appearance is in keeping with the criteria for Buerger's disease with the exception of superficial migratory thrombophlebitis. The absolute basis of treatment has been the total definitive discontinuation of smoking. Platelet anti-aggregant agents have also been used. Aside from limited resections of distal gangrenous regions (168 cases), surgery has been limited to lumbar sympathectomy without adrenalectomy (154 cases). Out of 133 patients regularly followed up for more than one year, results were good in 102 patients. The 39 poor results occurred exclusively in patients who continued or restarted smoking.