Make an Appointment
Talk to DoctorOverview
Buerger’s disease, also referred to as thromboangiitis obliterans, is a rare condition that primarily affects the blood vessels in the arms, legs, fingers, and toes. This disease involves inflammation of the blood vessels, which hampers the smooth flow of blood through them. As a result, blockages can occur within the vessels due to the formation of blood clots.
Buerger disease causes pain and tissue damage that begins in the fingers and toes and spreads to the arms and legs. Buerger’s disease typically presents its initial symptoms in the foot region. The injury can cause infection and death of body tissue (gangrene). This happens due to lack of blood flow damages or destroys skin tissue over time.
The most effective approach to alleviate the symptoms of Buerger’s disease is often to quit smoking. Individuals who continue smoking may eventually require surgical intervention to remove affected fingers and toes. This condition predominantly affects individuals who smoke cigarettes or use different forms of tobacco, such as chewing tobacco.
Symptoms
Severe pain in the arms and legs is one of the first indicators of Buerger’s illness. This ache occurs when the body is at rest. The symptoms appear gradually over time. It may include:
- Numbness, tingling or burning sensation in the fingers or toes.Raynaud’s syndrome, a disorder that affects small blood vessels in your fingers and toes. It causes the fingers and toes to turn white then blue when exposed to cold. Such color changes may be more or less visible depending on one’s skin tone.
- Skin color changes in the hands and feet. The skin can appear pale gray, red, or blue.
- Walking causes ankle, foot, or leg pain.
- Open sores on the fingers and toes.
- Inflammation of a vein just beneath the skin’s surface caused by a blood clot.
- Cramping of the muscles
- Gangrene
If any signs or symptoms persist or if there is a suspicion of having Buerger’s disease, it is advisable to seek medical attention to obtain an accurate diagnosis and appropriate treatment.
Causes
The precise cause of Buerger’s disease remains unknown, despite various theories proposed by researchers. One prevailing belief is that the chemicals found in tobacco have the potential to harm the inner lining of blood vessels, possibly contributing to the development of Buerger’s disease. Another hypothesis suggests that the condition may involve an autoimmune response, wherein the immune system mistakenly attacks healthy tissue. Additionally, some researchers propose that certain individuals possess genetic factors that make them more susceptible to Buerger’s disease.
Risk factors
Several risk factors are identified to increase one’s risk of developing Buerger disease, such as:
- Age: People between the ages of 20 and 45 have an increased risk of this condition.
- Gender: Men or people assigned male at birth have higher risk of acquiring Buerger disease.
- Tobacco use: People who smoke cigarettes, use cigars, make, or chew tobacco are susceptible to the Buerger disease.
- Use of marijuana: Prolonged use of marijuana or cannabis increases the risk of blood vessel abnormalities comparable to those seen in Buerger disease.
Diagnosis
Buerger disease cannot be diagnosed with a test. However, testing can be performed to rule out other common illnesses that may cause similar symptoms.
The doctor may require the following tests:
- Blood tests: Diabetes, blood-clotting disorders, and autoimmune disorders such as scleroderma or lupus may all be detected by blood tests.
- Examination of the arteries in hands and feet: This test is frequently performed in a vascular laboratory. During the exam, blood pressure cuffs and ultrasound imaging are employed to observe how blood flows through the hands and feet. Other tests to assess blood flow to the skin may be performed.
- Imaging tests: During the procedure, a specific dye may be administered via IV prior to the photos being taken. The dye makes the arteries more visible in the photographs. CT or MRI scans can measure the amount of blood flowing via the arteries.
- Angiogram: This is a type of imaging test that reveals the blood arteries and blood flow in the body. During the procedure, a catheter is placed into a blood vessel, and a dye, commonly known as contrast, is delivered through the catheter to arteries in the heart. The dye makes the arteries more visible on X-ray images and video. This allows healthcare provider to see blockages in the hands and feet’s very small blood vessels.
Treatment
While there is currently no known treatment or cure for Buerger’s disease, the most effective approach to prevent its progression is to quit smoking, including marijuana and nicotine products. Even smoking as few as one cigarette per day can exacerbate the condition. It is important to note that exposure to secondhand smoke should also be avoided.
The use of electronic cigarettes, vaping, and nicotine replacement products is not recommended as options for individuals with Buerger’s disease. Nicotine, which is present in these products, is believed to irritate blood vessels and can potentially worsen the condition. In order to assist individuals in quitting smoking, doctors may suggest various interventions and strategies aimed at smoking cessation.
Participating in a live-in program at a treatment center or hospital can be beneficial for individuals looking to quit smoking. These programs typically involve spending several days or weeks in a supportive environment, where individuals can receive guidance and assistance in overcoming cigarette cravings. Through such programs, individuals can learn effective strategies to cope with cravings and develop a healthier, non-smoking lifestyle.
When people with Buerger’s disease quit smoking, their symptoms typically improve. When people stop smoking, the disease goes into remission.
While quitting smoking is the most effective approach, there are additional treatment options available to manage the symptoms of Buerger’s disease. These treatments, although not as impactful as smoking cessation, can provide some relief.
- Medicines: Specific medications can help with the symptoms of Buerger’s disease such as anticoagulants, vasodilators, analgesics, antibiotics, and medicines to prevent inflammation.
In cases of severe symptoms associated with Buerger’s disease, a medication named bosentan may be considered as a potential treatment option. Although its primary approval is for managing pulmonary hypertension, a few studies have indicated that bosentan could enhance blood flow in individuals with Buerger’s disease.
Vasodilators, such as calcium channel blockers, can improve blood flow. Anticoagulants can help prevent blood clots. Antibiotics can be used to treat ulcers. - Compression therapy: This is a typical treatment for increasing blood flow in the arms or legs. This is done by wearing a sleeve over the injured arm or leg and is then linked to a pump. The pump alternately pumps air into the sleeve. The sleeve inflates, gently squeezing the affected part of the body. During the treatment, blood flow to the affected area is increased through pressure.
- Surgery or other procedures: Amputation is necessary in situations where infection or tissue death occurs in an affected arm or leg. Buerger’s disease results in a significant reduction in blood flow, leading to potential damage or necrosis of the skin tissue.
