About thromboangiitis obliterans

What is thromboangiitis obliterans?

General Discussion

Buerger's disease, also known as thromboangiitis obliterans, is a rare disorder that, in most cases, affects young or middle-aged male cigarette smokers. It is characterized by narrowing or blockage (occlusion) of the veins and arteries of the extremities, resulting in reduced blood flow to these areas (peripheral vascular disease). The legs are affected more often than the arms. In most cases, the first symptom is extreme pain of the lower arms and legs while at rest. Affected individuals may also experience cramping in the legs when they walk that, in rare cases, may cause limping (claudication). In addition, affected individuals may have sores (ulcers) on the extremities, numbness and tingling and a lack of normal blood flow to the fingers and/or toes when exposed to cold temperatures (Raynaud's phenomenon), and/or inflammation and clotting of certain veins (thrombophlebitis). In severe cases, individuals with Buerger's disease may exhibit tissue death (gangrene) of affected limbs. The exact cause of Buerger's disease is not known; however, most affected individuals are heavy tobacco users.

What are the symptoms for thromboangiitis obliterans?

Symptoms most often affect 2 or more limbs and may include:

  • Fingers or toes that appear pale, red, or bluish and feel cold to the touch.
  • Sudden severe pain in the hands and feet. The pain may feel like a burning or tingling.
  • Pain in the hands and feet that most often occurs when at rest. The pain may be worse when the hands and feet get cold or during emotional stress.
  • Pain in the legs, ankles, or feet when walking (intermittent claudication). The pain is often located in the arch of the foot.
  • Skin changes or small painful ulcers on the fingers or toes.
  • Occasionally, arthritis in the wrists or knees develops before the blood vessels become blocked.

What are the causes for thromboangiitis obliterans?

Thromboangiitis obliterans (Buerger disease) is caused by small blood vessels that become inflamed and swollen. The blood vessels then narrow or get blocked by blood clots (thrombosis). Blood vessels of the hands and feet are mostly affected. Arteries are more affected than veins. Average age when symptoms begin is around 35. Women and older adults are affected less often.

This condition mostly affects young men ages 20 to 45 who are heavy smokers or chew tobacco. Female smokers may also be affected. The condition affects more people in the Middle East, Asia, the Mediterranean, and Eastern Europe. Many people with this problem have poor dental health, most likely due to tobacco use.

What are the treatments for thromboangiitis obliterans?

There is no cure for thromboangiitis obliterans. The goal of treatment is to control symptoms and prevent the disease from getting worse.

Stopping tobacco use of any kind is key to controlling the disease. Smoking cessation treatments are strongly recommended. It is also important to avoid cold temperatures and other conditions that reduce blood flow in the hands and feet.

Applying warmth and doing gentle exercises can help increase circulation.

Aspirin and medicines that open the blood vessels (vasodilators) may help. In very bad cases, surgery to cut the nerves to the area (surgical sympathectomy) can help control pain. Rarely, bypass surgery is considered in certain people.

It may become necessary to amputate the fingers or toes if the area becomes very infected and tissue dies.

What are the risk factors for thromboangiitis obliterans?

Tobacco use

Cigarette smoking greatly increases your risk of Buerger's disease. But Buerger's disease can occur in people who use any form of tobacco, including cigars and chewing tobacco.

People who smoke hand-rolled cigarettes using raw tobacco and those who smoke more than a pack and half of cigarettes a day may have the greatest risk of Buerger's disease. The rates of Buerger's disease are highest in areas of the Mediterranean, Middle East and Asia where heavy smoking is most common.

Chronic gum disease

Long-term infection of the gums has been linked to the development of Buerger's disease, though the reason for this connection isn't yet clear.


Buerger's disease is far more common in males than in females. However, this difference may be linked to higher rates of smoking in men.


The disease often first appears in people less than 45 years old.

Is there a cure/medications for thromboangiitis obliterans?

Thromboangiitis obliterans is a rare disease in which blood vessels of the hands and feet become blocked.

  • A non-atherosclerotic, segmental inflammatory condition known as Buerger's disease (thromboangiitis obliterans) typically affects the small and medium-sized arteries, veins, and nerves in the upper and lower extremities.
  • The origin is uncertain; however, it includes immunological and coagulation responses, cigarette exposure, and inherited vulnerability.
  • Revascularization is frequently not an to treat the problem.
  • Patients with significant consequences, such as ischemic ulcers or rest discomfort, may benefit from pharmacological treatment.
  • Although there is no test that can definitively determine whether you have Buerger's disease, your doctor will probably request testing to either confirm the suspicion of Buerger's disease based on your signs and symptoms or to rule out other more prevalent disorders.
  • Thromboangiitis obliterans are incurable. Controlling symptoms and preventing the disease from getting worse are the goals of treatment.
  • Buerger's illness has no known treatment. Stopping all tobacco use is the only method to prevent Buerger's disease from getting worse. •Although most medicines don't effectively treat the disease, they can assist manage its symptoms. Surgery might improve some places' blood flow. A few cigarettes a day can make the condition worse.

Fingers or toes that appear pale, red, or bluish,Cold hands or feet,Pain in the hands and feet that may feel like burning or tingling

Blood vessels become inflamed, swell and can become blocked with blood clots (thrombi)


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