Study note

Buerger disease: distal vascular involvement and smoking

THE CONTEXT

Buerger disease, also called thromboangiitis obliterans, is an inflammatory arterial disease distinct from atherosclerosis.

•

It usually presents in male smokers aged 20–30 years and is commonest in people from the Mediterranean and North Africa.

•

Distal arterial involvement causes claudication in the feet or rest pain in the fingers or toes.

•

Wrist and ankle pulses are absent, while brachial and popliteal pulses remain present.

•

Venous involvement may cause superficial thrombophlebitis.

•

The disease often remits when the patient stops smoking.

•

Vasodilators such as prostacyclin and calcium antagonists, or sympathectomy, may provide symptomatic benefit.

•

Major limb amputation is the most frequent outcome when patients continue smoking.

NEETx

Learn. Practise. Remember.