Buerger’s Disease

<p>Also known as Thromboangiitis obliterates (TAO) is a rare disorder characterized by inflammation of the small and medium arteries and veins.</p><p>In Buerger&#x27;s disease, your blood vessels swell and can become blocked with blood clots (thrombi). This eventually damages or destroys skin tissues and may lead to infection and gangrene. Buerger&#x27;s disease usually first shows in the hands and feet and may expand to affect larger areas of your arms and legs.</p><p>The inflammation in TAO frequently leads to blockages of arteries in the lower segments of the arms and legs, and may cause claudication or rest pain and non-healing sores or ulcers, a condition known as Critical Limb Ischemia (CLI).</p><p>Virtually everyone diagnosed with Buerger&#x27;s disease smokes cigarettes or uses other forms of tobacco, such as chewing tobacco. Quitting all forms of tobacco is the only way to stop Buerger&#x27;s disease. For those who don&#x27;t quit, amputation of all or part of a limb may ultimately be necessary<br>.</p><p>Risk Factors</p><p>Exclusively in individuals with a history of tobacco exposure of any kind, including smoking, chewing, or snuff Age (predominately 20 to 40 years old) More common in men High cholesterol, high blood pressure, or diabetes.</p><p>Symptoms</p><p>Buerger&#x27;s disease symptoms include:</p><p>Pain and weakness in your legs and feet or your arms and hands</p><p>Swelling in your feet and hands</p><p>Fingers and toes that turn pale when exposed to cold (Raynaud&#x27;s phenomenon)</p><p>Open sores on your fingers and toes</p><p>Temperature changes in affected areas</p><p>Ulceration and gangrene</p><p>Diagnosis</p><p>Arteriography - may indicate a proximal source of emboli. It is the most conclusive diagnostic procedure for peripheral vascular diseases.</p><p>Ultrasound - may indicate presence of distal extremity ischemia (indicated by claudication, pain at rest, ischemic ulcers or gangrene)</p><p>There are several key factors physicians use to diagnose<br>:</p><p>Rest pain or ulceration under 50 years of age tobacco use Tests indicating the arteries are blocked. Typical tests include artery blood flow measurements (such as the ABI or ultrasound), arteriography (pictures of the affected blood vessel obtained by injecting a dye via catheter), and/or biopsy of the affected artery.No other explanation for artery blockage or clot development. A physician would want to be sure that a clot did not develop from the heart or a large blood vessel and travel to the arm or leg (an embolus). The doctor would also want to be certain there had been no blood vessel injury or trauma, no local lesions such as a blood vessel cyst, no autoimmune diseases such as scleroderma, and no blood clotting diseases.</p><p>Treatment</p><p>A person with this disease must stop smoking, or it will relentlessly worsen, and ultimately an amputation may be necessary. Also, the person should avoid exposure to the cold; injuries from heat, cold, or substances such as iodine or acids used to treat corns and calluses; injuries from poorly fitting shoes or minor surgery (such as trimming calluses); fungal infections; and drugs that can narrow blood vessels. Walking 15 to 30 minutes twice a day is recommended, except for people with gangrene, sores, or pain at rest; they may need bed rest. People should protect their feet with bandages that have heel pads or with foam-rubber booties. The head of the bed can be raised on 6- to 8-inch blocks so gravity helps blood flow through the arteries.</p>