Also known as:
Buerger's disease, also known as thromboangiitis obliterans, is a rare disorder that, in most cases, affects young or middle-aged male cigarette smokers.
It is characterized by narrowing or blockage (occlusion) of the veins and arteries of the extremities, resulting in reduced blood flow to these areas (peripheral vascular disease). The legs are affected more often than the arms.
In most cases, the first symptom is extreme pain of the lower arms and legs while at rest. Affected individuals may also experience cramping in the legs when they walk that, in rare cases, may cause limping (claudication).
In addition, affected individuals may have sores (ulcers) on the extremities, numbness and tingling and a lack of normal blood flow to the fingers and/or toes when exposed to cold temperatures (Raynaud's phenomenon), and/or inflammation and clotting of certain veins (thrombophlebitis).
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What is Buerger disease?Buerger disease is one of many types of vasculitis. This is inflammation of small and medium size blood vessels. Buerger disease causes a tightening, or a blockage, of the blood vessels in your feet and hands. When blood doesn’t flow well to your hands and feet, especially during activity, you may have pain and tissue damage. In the worst cases, sores (ulcers) appear on your fingers and toes due to poor circulation to the skin and tissue. The ulcers can become infected and cause gangrene. In a small number of people, Buerger disease reduces blood flow to the heart, belly, or brain.
Who is at risk for Buerger disease?People at the greatest risk for Buerger disease are those who are heavy smokers. Men of Asian or Eastern European descent, who are between ages 20 and 40 seem to be especially at risk. It has also been identified cigar smokers, marijuana users, and those who use smokeless tobacco such as chewing tobacco and snuff. It is a rare disorder, especially in countries where the use of tobacco has declined.
What causes Buerger disease?Healthcare providers are not sure what causes Buerger disease. It is a rare type of vasculitis.
What are the symptoms for Buerger disease?
Symptoms of Buerger disease include:
- Pain, tenderness or burning feeling in your lower legs or feet when walking
- Pain or tenderness in your hands or forearms
- Blood clots
- Ulcers on your toes and fingers
- Change in the color of the skin on the fingers and toes to pale, redness, and sometimes bluish in color
How is Buerger disease diagnosed?
To make a diagnosis, your healthcare provider will consider:
- Your overall health and medical history
- Your symptoms
- Lifestyle choices, such as whether you smoke
- A physical exam
- Blood tests
- Imaging tests to assess tissue damage
How is Buerger disease treated?
Your healthcare provider will figure out the best treatment based on:
- How old you are
- Your overall health and medical history
- How sick you are
- How well you can handle specific medicines, procedures, or therapies
- How long the condition is expected to last
- Your opinion or preference
There is no cure for Buerger disease. Treatment may depend on how far your disease has progressed. It will focus on trying to improve blood flow to the affected area or to reduce pain. Choices include:
- Stopping all smoking and other forms of tobacco use, including electronic cigarettes.
- Having surgery to bring blood to the affected tissues
- Other types of surgery to cut the nerves to the tissue to reduce pain or treat damaged extremities
Some medicines help to relax the blood vessels and improve blood flow to the tissue.
What are the complications of Buerger disease?
Possible complications from Buerger disease include:
- Changes in the way you walk or move due to pain
- Tissue damage or tissue death (gangrene)
What can I do to prevent Buerger disease?
The goal is to prevent the disorder from getting worse by
- Stopping smoking and avoiding all tobacco products.
- Avoid long periods of time spent in cold temperatures.
- Dressing warmly in cold temperatures.
How can I manage Buerger disease?Follow your healthcare provider’s advice for taking care of yourself. The best way to stop or slow Buerger disease is to stop using tobacco completely. Talk with your healthcare provider if you need help quitting tobacco.
When should I call my healthcare provider?
Talk to your healthcare provider if you have:
- Pain in your lower legs, feet, hands, or forearms that continues to get worse
- Sores on your hands or feet that do not heal
- Signs of infection in the affected areas
Key points about Buerger disease
- Buerger disease causes the blood vessels to narrow and severely limits the blood flow to the area, usually in the hands and feet.
- It is a rare disorder that can’t be prevented. It affects men more frequently than women.
- Quitting smoking and stopping use of any forms of tobacco or nicotine is important to reduce the risk of complications.
Next stepsTips to help you get the most from a visit to your healthcare provider:
- Know the reason for your visit and what you want to happen.
- Before your visit, write down questions you want answered.
- Bring someone with you to help you ask questions and remember what your provider tells you.
- At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
- Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
- Ask if your condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if you do not take the medicine or have the test or procedure.
- If you have a follow-up appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your provider if you have questions.