Buerger’s disease, also known as thromboangitis obliterans, is a type of vasculitis in which there is acute inflammation, and clotting of the arteries and veins of the feet and hands. Inflammation and clotting problems can lead to:

  • Blockages of the arteries in the lower extremities (arms and legs)
  • Critical limb ischemia
  • Claudication
  • Pain at rest
  • Non-healing sores and ulcers in the hands or feet

Buerger’s disease occurs almost exclusively in heavy smokers. Unlike peripheral arterial disease, it is not caused by atherosclerosis (a build-up of plaque in the arteries). 

Symptoms

The most common symptoms of Buerger’s disease are:

  • Pain in the hands and feet during exercise due to reduced blood-flow
  • Pain at Rest
  • Skin ulcerations
  • Gangrene of the fingers and toes in severe cases
  • Coldness, numbness or tingling of the hands and feet similar to Raynaud's syndrome

Risk Factors

Buerger’s disease occurs almost exclusively in heavy tobacco users, including those who smoke cigarettes or chew tobacco. It occurs most often in those between the ages of 20 and 40 years old and is more common in men and those with a history of high cholesterol, high blood pressure or diabetes.

Diagnosis

The symptoms of Buerger’s disease can mimic those of other vascular diseases. Therefore, a comprehensive evaluation is required to ascertain the actual cause or etiology of the condition. The following criteria are used in making the diagnosis:

  • Pain at rest
  • Ulceration in the hands or feet prior to age 50
  • Use of tobacco products
  • Arterial blockage or clot development not caused by atherosclerosis or other conditions

Diagnostic Tests

  • An angiogram to test for arterial blockage is the angiogram, an X-ray taken after the injection of contrast dye.

Treatment

Complete cessation of smoking or use of other tobacco use. Patients with Buerger’s disease who continue to smoke risk risk amputation of fingers, toes or other parts of the lower extremities.