无蒂和带蒂大网膜皮瓣
认为可改善跛行、减轻静息痛、并促进溃疡愈合。[50]Talwar S, Jain S, Porwal R, et al. Free versus pedicled omental grafts for limb salvage in Buerger's disease. Aust NZ J Surg. 1998;68:38-40.http://www.ncbi.nlm.nih.gov/pubmed/9440454?tool=bestpractice.com
基因转染
肌内注射血管内皮生长因子在改善侧支血管结构方面初步效果较好。[51]Isner JM, Baumgartner I, Rauh G, et al. Treatment of thromboangiitis obliterans (Buerger's disease) by intramuscular gene transfer of vascular endothelial growth factor: preliminary clinical results. J Vasc Surg. 1998;28:964-973.http://www.ncbi.nlm.nih.gov/pubmed/9845647?tool=bestpractice.com
自体骨髓细胞移植
通过多次向腓肠肌内注射移植自体骨髓细胞可改善侧支血管结构。据报道,此疗法可改善踝臂指数、经皮氧浓度、静息痛、无痛行走距离、溃疡愈合和保肢率。[52]Tateishi-Yuyama E, Matsubara H, Murohara T, et al. Therapeutic angiogenesis for patients with limb ischaemia by autologous transplantation of bone-marrow cells: a pilot study and a randomized controlled trial. Lancet. 2002;360:427-435.http://www.ncbi.nlm.nih.gov/pubmed/12241713?tool=bestpractice.com[47]Fadini GP, Agostini C, Avogaro A. Autologous stem cell therapy for peripheral arterial disease: meta-analysis and systematic review of the literature. Atherosclerosis. 2010;209:10-17.http://www.ncbi.nlm.nih.gov/pubmed/19740466?tool=bestpractice.com对不适宜行血管成形术或血运重建术的患者,自体骨髓单个核细胞 (BM-MNC) 移植可降低截肢率。在一项非随机试验中,有静息痛和未愈合溃疡的 Buerger 病患者 (n=26) 在接受 BM-MNC治疗后,4 年未截肢率为 95%,与之相比,未接受 BM-MNC 治疗的患者 (n=16) 的未截肢率为 6%。[53]Idei N, Soga J, Hata T, et al. Autologous bone-marrow mononuclear cell implantation reduces long-term major amputation risk in patients with critical limb ischemia: a comparison of atherosclerotic peripheral arterial disease and Buerger disease. Circ Cardiovasc Interv. 2011;4:15-25.http://circinterventions.ahajournals.org/content/4/1/15.full.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/21205941?tool=bestpractice.com
波生坦
据报道,已有 2 名患者的手指坏疽症因使用此种内皮素受体拮抗剂后得到改善。[54]Todoli Parra JA, Hernández MM, Arrébola López MA. Efficacy of bosentan in digital ischemic ulcers. Ann Vasc Surg. 2010;24:690.e1-e4.http://www.ncbi.nlm.nih.gov/pubmed/20579585?tool=bestpractice.com