Buerger disease is a rare disease of the arteries and veins in the arms and legs. In Buerger disease — also called thromboangiitis obliterans — blood vessels become blocked. This reduces blood flow to the affected areas. Blood clots may form in the blood vessels.
Over time, the lack of blood flow damages or destroys skin tissue. The damage can lead to infection and death of body tissue, called gangrene. Buerger disease is usually first seen in the feet. It may eventually affect the blood vessels of the hand. Blood clots may form in the small veins of the arms and legs.
People who get Buerger disease almost always smoke cigarettes or use other forms of tobacco, such as chewing tobacco. Quitting all forms of tobacco is the only way to stop Buerger disease. For those who don't quit, surgery to remove fingers and toes might be needed.
Buerger disease symptoms include:
See a health care provider if you think you have symptoms of Buerger disease.
The exact cause of Buerger disease is unknown. The condition is strongly linked to tobacco use. It's thought that chemicals in tobacco may hurt the lining of the blood vessels.
Experts think that some people have genes that make them more likely to get Buerger disease. It's also possible that the disease occurs when the body's immune system attacks healthy tissue by mistake.
The biggest risk factor for Buerger disease is smoking or using any type of tobacco. The disease can occur in people who smoke cigarettes, use cigars and chew tobacco. The rates of Buerger disease are highest in areas of the Mediterranean, Middle East and Asia where heavy smoking is most common.
Some research says that long-term use of marijuana, also called cannabis, also raises the risk of blood vessel problems similar to those of Buerger disease.
Other risk factors for Buerger disease include being male and being younger than 45 years old. Long-term infection of the gums in the mouth may also increase the risk. But more study is needed to confirm this link.
Buerger disease decreases blood flow to the hands and feet. As the disease gets worse, the skin and tissue in the affected areas do not get enough blood. This can cause painful open sores that do not heal. The sores may lead to a complication called gangrene.
Symptoms of gangrene include black or blue skin, a loss of feeling in the affected finger or toe, and a bad smell from the area. Gangrene is a serious condition. Surgery is usually needed to remove the affected finger, toe or other tissue.
Nearly everyone who has Buerger disease has smoked or used some form of tobacco. To prevent Buerger disease, it's important to not use tobacco.
Quitting smoking can be hard. Talk to a health care provider about ways to quit.
There's no test that can diagnose Buerger disease. But tests can be done to check for other common conditions that may cause similar symptoms.
Tests may include:
There's no cure for Buerger disease. The only proven treatment for Buerger disease is to quit using all tobacco products. Even one cigarette a day can make the disease worse. This includes using electronic cigarettes, vaping and using marijuana.
If you have Buerger disease and smoke or use tobacco in any form, talk to your health care provider about ways to quit. Nicotine replacement products aren't an option because they still have nicotine in them. Nicotine is thought to irritate the blood vessels. Your health care provider can recommend other medicines that might help.
Another option is a live-in program to help you stop smoking. You typically stay at a treatment center or hospital for a few days or weeks. You'll learn how to stop cravings for cigarettes and how to live tobacco-free.
Other treatments for Buerger disease symptoms are available, but they don't work as well as quitting smoking. Those treatments may include medicines, compression therapy and surgery.
If you have Buerger disease, your health care provider may recommend medicine to improve blood flow. For example, some blood pressure medicines may be helpful. Aspirin may be given to prevent blood clots.
A medicine called bosentan (Tracleer) may be tried if you have very severe Buerger disease symptoms. It's approved to treat high blood pressure in the lungs. But a few studies showed that it improved blood flow in people with Buerger disease.
Other medicines depend on your symptoms and other health conditions. Medicines may be given to treat pain or heal skin sores.
If you have Buerger disease, your provider may suggest a medicine-free treatment called compression therapy. Your health care provider may call this treatment intermittent pneumatic compression pumping. This treatment puts pressure on the affected body area to improve blood flow.
During compression therapy, you wear a sleeve over the affected arm or leg. The sleeve connects to a pump. The pump sends air into the sleeve on and off. The sleeve inflates, gently squeezing the affected body area. The pressure increases blood flow to the area.
Buerger disease causes a severe lack of blood flow, which can damage skin tissue or cause it to die. Surgery may be needed to remove an arm or leg that's infected or has dead tissue. This surgery is called amputation.
To improve symptoms of Buerger disease and prevent complications, take the following steps:
You're likely to start by seeing your primary care provider. If you have symptoms of Buerger disease, you may be referred to a provider trained in blood vessel diseases. This type of health care provider is called a vascular specialist.
Take someone along to your health care provider's visit, if possible. Someone who goes with you can help you remember information you're given.
Make a list of:
Some basic questions to ask include:
Don't hesitate to ask other questions as well.
Your health care provider might ask:
