Buerger's disease
(Thromboangiitis obliterans)
Segmental non-atherosclerotic inflammatory condition of arteries and veins characterised by thrombosis and recanalisation of small and medium vessels.
- Impaired vasorelaxation and function of the sympathetic system
- Ensuing inflammatory process leads to vessel thrombosis
Risk factors
[edit | edit source]- Males
- Smokers (heavy, long-term)
- Around 40 years old
Locations
[edit | edit source]- Most commonly upper/lower extremities
- Look for symptoms in two extremities
Presentation
[edit | edit source]- Distal extremity ischaemia - most common
- Ischaemic ulcers
- Gangrene
- Raynaud's
- Distal claudication
- Instep claudication
- Superficial thrombophlebitis
Diagnosis
[edit | edit source]- Generally a diagnosis of exclusion
- Exclude PAD/occlusive disease
- Olin criteria
- Age <45
- History tobacco use
- Distal extremity ischaemia
- Arteriographic findings
- Other causes ruled out
Adjuncts
[edit | edit source]- Pain control
- Local wound care
Prognosis
[edit | edit source]- Disease progression halted in patients that quit smoking
- Risk of amputation highly correlated with smoking status