Your Health

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.
Other risk factors include:
  • Gender: males
  • Age: 20-40 years old
  • Geographic location: Eastern Europe, the Mediterranean, and Asian countries (Buerger's disease is not very common in the US.)

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 (eg, 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, such as:
  • Fatty plaque build-up in arteries
  • Other diseases that cause inflammation in blood vessels
  • Raynaud’s phenomenon without any underlying condition
  • Blood clotting disorders
Your doctor will:
  • Ask about your medical history, especially focusing on your tobacco use
  • Ask about your symptoms
  • Do a physical exam (including tests to check your circulation)
  • Order blood tests
Your doctor may also order an angiogram . With this test, a chemical is injected into your blood vessels to make them more visible on an x-ray . This test can help your doctor see any blockages in blood flow.

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 medicines (eg, to relieve pain, to widen blood vessels)
  • 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.

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/index%5Fe.html/

References

Buerger’s disease. The Johns Hopkins Vasculitis Center website. Available at: http://www.hopkinsvasculitis.org/types-vasculitis/buergers-disease/. Accessed June 7, 2012.

Buerger’s disease. Vasculitis Foundation website. Available at: http://www.vasculitisfoundation.org/buergersdisease. Accessed June 7, 2012.

Buerger’s disease (thromboangitis obliterans). UC Davis Health System website. Available at: http://www.ucdmc.ucdavis.edu/vascular/diseases/buergers%5Fdisease.html. Accessed June 7, 2012.

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: impact on Buerger's disease. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/tobacco/campaign/tips/resources/overviews/buergers-disease.html. Updated March 16, 2012. Accessed June 7, 2012.

Thromboangiitis obliterans. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/. Updated January 21, 2011. Accessed June 7, 2012.

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