Prevention and Treatment of Buerger Disease (Thromboangiitis Obliterans)


Thromboangiitis obliterans or Buerger Disease is a rare disease in which blood vessels of the hands and feet become blocked. It is a non-atherosclerotic inflammatory disease affecting small and medium sized arteries and veins of upper and lower extremities. This eventually damages or destroys skin tissues and may lead to infection and gangrene. Buerger's disease usually first shows in the hands and feet and may eventually affect larger areas of your arms and legs.

Buerger disease is characterized by the absence or minimal presence of atheromas, segmental vascular inflammation, vasoocclusive phenomenon, and involvement of small- and medium-sized arteries and veins of the upper and lower extremities.

The first reported case of thromboangiitis obliterans was described in Germany by von Winiwarter in an 1879 article titled "A strange form of endarteritis and endophlebitis with gangrene of the feet. Buerger's disease is rare in the United States, but is more common in the Middle East and Far East. Buerger's disease usually affects men younger than 40 years of age, though it's becoming more common in women.

Symptoms:
  • Hands or feet may be pale, red, or bluish
  • Hands or feet may feel cold
  • Pain in the hands and feet : Acute, severe, Burning or tingling, Often occurring at rest
  • Pain in the legs, ankles, or feet when walking (intermittent claudication) : Often located in the arch of the foot
  • Skin changes or ulcers on hands or feet

Note: Symptoms may worsen with exposure to cold or with emotional stress. Usually, two or more limbs are affected.


Prevention of Buerger Disease (Thromboangiitis Obliterans)

Those with a history of Raynaud's disease or thromboangiitis obliterans should avoid all tobacco use.


Treatment of Buerger Disease (Thromboangiitis Obliterans)
  • There is no cure for thromboangiitis obliterans. The goal of treatment is to control symptoms.
  • The patient must stop using tobacco and should avoid cold temperatures and other conditions that reduce circulation to the hands and feet.
  • Applying warmth and exercising gently may help increase circulation.
  • Cutting the nerves to the area (surgical sympathectomy) may help control pain. Aspirin and vasodilators may also used. It may be necessary to amputate the hand or foot if infection or widespread tissue death occurs.
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