Buergers

Disease
A presentation by Jennifer Kent-Baker
Buergers Disease: What It Is

Buerger's disease (thromboangiitis obliterans) is a

rare disease characterized by a combination of
acute inflammation and thrombosis of the arteries
and veins in the hands and feet. The obstruction of
blood vessels in the hands and feet reduces the
availability of blood to the tissues, causes pain and
eventually damages or destroys the tissue. It often
leads skin ulcerations and gangrene of fingers and
toes. Rarely, in advanced stages of the disease, it
may affect vessels in other parts of the body.
Buergers Disease: Appearance
Ulcers and Gangrene caused by Buergers Disease
Buergers Disease: Who It Affects

Buerger's disease affects approximately six out of

every 10,000 people. It almost always affects men,
ages 20 to 40, who smoke or chew tobacco.
Recently, however, more women and men over the
age of 50 have been diagnosed with Buerger's
disease. This disorder is still very uncommon in
children, but it may occur in those with autoimmune
diseases. Buerger's disease is most common in the
Orient, Southeast Asia, India and the Middle East,
but is rare among African-Americans.
Buergers Disease: Symptoms
Enlarged, red, tender cord-like veins
Pain or tenderness
Numbness and tingling in the limbs
Skin ulcers or gangrene of the digits

Discoloration
Two or more limbs affected
Pain may increase with activity such as walking and decrease
with rest
Pulse may be decreased or absent in the affected extremity
Symptoms may worsen with exposure to cold or with emotional
stress
Buergers Disease: The Cause

Buerger's disease is greatly associated with

heavy to moderate tobacco use, both
cigarette and smokeless. The disease is an
autoimmune reaction triggered by tobacco.
Buergers Disease: Diagnosing
Buerger's disease is often masked by a wide variety of other
diseases that cause diminished blood flow to the hands and feet,
therefore, other disorders must be ruled out with aggressive
evaluation.

Blockage of blood vessels in the hands and feet caused by

Buerger's disease may be detected by one of the following
methods:

An angiogram or an arteriogram of the upper and lower

extremities
A Doppler ultrasound

Skin biopsies are rarely used because of concern that the biopsy
site near an area with poor blood circulation will not heal.
Normal and Abnormal Angiograms
Buergers Disease: Angiogram
Angiogram of the Hand

Normal In Buergers Disease

Buergers Disease: Prevention

To avoid the onset of Buerger's disease,

tobacco use should be avoided, particularly
by men.
Buergers Disease: Treatment

The only method known to be an effective

treatment for Buerger's disease is
immediately quitting smoking. Patients who
continue to smoke after a diagnosis of
Buerger's disease will generally require
amputation of the fingers and toes.

Since there is no cure for Buerger's disease,

the goal of treatment is to control symptoms.
Buergers Disease: Symptom Control

Gentle massage and warmth to increase circulation

Avoid conditions that reduce circulation to the
extremities
Avoid sitting or standing in one position for long
periods
Do not walk barefoot to avoid injury
Do not wear tight or restrictive clothing
Report all injuries to physician for appropriate
treatment
Buergers Disease: Prognosis
The symptoms of Buerger's disease may
disappear if tobacco use is stopped. If the
affected extremity is to be saved, the patient
must stop smoking. If infection or gangrene
occurs, amputation of the affect extremity
may be necessary.
Some People Just CANT Quit!
(Even if it costs an arm & a leg!)