Buerger's disease, also called thromboangiitis obliterans, is a rare disease of the blood vessels of the arms and legs. It's characterized by a combination of inflammation and clots in the arteries and veins that obstructs blood flow. Buerger's disease usually affects men between ages 20 and 40. It's more common in the Middle East and the Far East. The cause of Buerger's disease isn't clear. But it's strongly associated with smoking. Stopping smoking usually improves the problem. Also, some research suggests that arsenic poisoning may play a role in the disease. The disease restricts or blocks blood flow to the arms and legs, beginning with the hands, fingers and feet. This eventually damages or destroys tissues and makes them more prone to infections and gangrene. Signs and symptoms of Buerger's disease include: Pain or tenderness in the fingers, hands or forearms Pain in the toes, feet, ankles or legs Skin changes (atrophy) or ulcers in the fingers and toes Fingers and toes turning white or blue in response to cold or strong emotions (Raynaud's phenomenon) — this is due to blood vessel spasms resulting in less blood flow to fingers and toes Visible short segments of enlarged, red and tender surface veins A doctor may confirm a diagnosis of Buerger's disease by: Angiogram Ultrasound Biopsy of an affected blood vessel There's no specific treatment for Buerger's disease. Treatment is directed at managing the signs and symptoms and may include: Stopping smoking Surgery to cut certain nerves to the affected area (surgical sympathectomy) to help control the pain Amputation, if gangrene occurs Researchers are studying the effectiveness of clot-busting drugs (thrombolytics) in reducing the risk of amputation in people with Buerger's disease. But this treatment is considered experimental. In addition, research indicates that intravenous (IV) iloprost, a drug that increases blood flow, may provide more pain relief than aspirin does in people with Buerger's disease. At this time, both of these treatments are available only in Europe. By Mayo Clinic staff January 6, 2003
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