Buerger's Disease (Thromoangiitis Obliterans)

Thromboangiitis obliterans is commonly called Buerger’s disease. This is a rare disease which causes inflammation and blood clots in the blood vessels of the arms and legs. The clots block the blood circulation causing inadequate supply of oxygen and nutrients to the tissues which eventually leads to tissue damage.  In severe cases, it can cause infection and gangrene necessitating amputation.

Causes

Buerger’s disease generally occurs in people who smoke cigarettes or chew tobacco. It affects mostly young men who are between the age of 20-40 years. This condition is uncommon amongst women and children. Buerger’s disease most commonly affects small and medium sized arteries more than veins.

Symptoms

The symptoms of Buerger’s disease include:

  • Pain in arms or legs
  • Fingers and toes appear pale, red or bluish
  • Burning and tingling sensation
  • Skin changes
  • Cold hands or feet
  • Sores on hands or feet
  • Swelling along veins

Diagnosis

Plethysmography and Doppler test are commonly used ultrasound methods for examining a blockage of blood vessels in the hands or feet. Your doctor may also order blood tests to be done. If the diagnosis is unclear, you might be asked for a biopsy test of the blood vessel.

Treatment

There is no explicit treatment for Buerger’s disease. Any treatment given will be aimed at controlling the symptoms and preventing worsening of the disease. You will be instructed to stop using tobacco in any form with referral to smoking cessation counsellors if needed.  Keeping your hands and feet warm and performing gentle exercises can help increase blood circulation. Medicines like anticoagulants and vasodilators may be recommended to improve circulation.

In severe cases, your doctor might recommend a sympathectomy, a surgery which involves cutting of nerves in the affected area to provide pain relief and increase blood flow. Amputation may be necessary in severe cases of gangrene.

Prevention

The following precautions should be taken to prevent Buerger’s disease.

  • Avoid cigarette smoking and chewing tobacco
  • Use well-fitting footwear to prevent trauma and infection
  • Avoid cold environment
  • Avoid vasoconstrictors
  • The American Board of  Orthopaedic Surgery
  • Allegheny General Hospital
  • University of Pittsburgh  Medical Center
  • University of Cincinnati College of Medicine
  • American Society for Surgery of the Hand
  • American Association for Hand Surgery: AAHS
  • Alpha Omega Alpha