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by Stahl RJ

Buerger’s Disease

(Thromboangiitis Obliterans)

Definition

Buerger’s disease is inflammation of blood vessels. This condition particularly affects the vessels in the hands and feet. Inflammation and blood clots can form and block blood flow, leading to pain, tissue damage, and even tissue death.

Causes

The exact cause is not known.

Risk Factors

The main risk factor is tobacco use. This includes smoking cigarettes , using chewing tobacco, smoking cigars, or using any other type of tobacco.
Certain people are at increased risk. Buerger's disease is more common in men and in people age 20-40 years old. It is also more common in people who live in Eastern Europe and Asian countries. Buerger's disease is not common in the United States.

Symptoms

The symptoms are due to blood not being able to flow properly. People with this condition usually first have problems in their hands and feet. They may experience:
  • Pain, numbness, burning sensation, and tingling
  • Cold hands and feet
  • Skin discoloration (white, red, or bluish hands or feet)—These skin color changes may be triggered by certain factors, like being exposed to cold temperatures. This is called Raynaud’s phenomenom .
Buerger’s disease can lead to swelling under the skin, sores, and ulcers. The most serious complication is tissue death ( gangrene ). This may be occurring if the fingers turn black.
Tissue Death in the Foot
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Diagnosis

It may be difficult to diagnosis Buerger’s disease because the symptoms can be similar to other conditions. You will be asked about your symptoms and medical history. A physical exam will be done.
Your bodily fluids may be tested. This can be done with blood tests.
Images may be taken of your blood vessels. This can be done with an angiogram.

Treatment

After being diagnosed with Buerger’s disease, the most important step is to quit smoking . This can help to reduce the chance that the condition will get worse. There are many strategies to help you quit smoking that your doctor can talk to you about.
Other treatment options may include:
  • Having wounds properly cleaned and cared for
    • You will need to take special care of your skin. If your feet are numb, for example, you may not realize that you have a cut. Your doctor may ask you to carefully inspect your skin daily.
  • Taking medications
  • Exercising to improve circulation
  • Undergoing surgery to increase circulation and decrease pain
In severe cases, amputation may be needed to remove dead tissue. People who continue to smoke are at a greater risk of amputation.

Prevention

The best way to prevent Buerger’s disease is to not use tobacco products.

RESOURCES

National Heart, Lung, and Blood Institute
http://www.nhlbi.nih.gov
Vasculitis Foundation
http://www.vasculitisfoundation.org

CANADIAN RESOURCES

The Canadian Orthopaedic Association
http://www.coa-aco.org
Health Canada
http://www.hc-sc.gc.ca

References

Buerger’s disease. The Johns Hopkins Vasculitis Center website. Available at: http://www.hopkinsvasculitis.org/types-vasculitis/buergers-disease/. Accessed June 30, 2015.
Buerger’s disease. Vasculitis Foundation website. Available at: http://www.vasculitisfoundation.org/education/forms/buergers-disease/. Updated September 2012. Accessed June 30, 2015.
Buerger’s disease (thromboangitis obliterans). UC Davis Health System website. Available at: http://www.ucdmc.ucdavis.edu/vascular/diseases/buergers%5Fdisease.html. Accessed June 30, 2015.
Sekhar S,  Thomas D, Meera NK, Koneri RB, Balakrishna P. Progress and incidence of Buerger's disease in Bangalore. Internet J Epidemiol. 2008;6(1).
Smoking and Buerger's disease. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/tobacco/campaign/tips/diseases/buergers-disease.html. Updated March 13, 2015. Accessed June 30, 2015.
Thromboangiitis obliterans. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/. Updated January 21, 2011. Accessed June 30, 2015.

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