What is Buerger’s Disease? Know Symptoms, Causes And Treatment of This Rare Disease
Buerger's disease affects the small and medium arteries, as well as veins and nerves.
Buerger’s disease, also known as thromboangiitis obliterans, has a striking but poorly understood link to cigarette smoking. Buerger’s disease doesn’t really occur in the absence of tobacco exposure. Buerger’s disease affects the distal medium-sized veins and arteries, particularly the vessels near the ankles and wrists. Thrombotic obliterations that begin distally and progress proximally characterise the disease. Buerger’s disease is typically segmental, including 5- to 10-cm lengths of blood vessels. Arterial obliteration results in the formation of collateral vessels that appear as a “corkscrew” on angiography. Vascular occlusion in Buerger’s disease frequently results in digit loss and, if smoking continues, greater tissue loss (e.g., hands or feet). Despite the fact that the extremities are heavily involved in Buerger’s disease, internal organ disease almost never occurs.
Dr Chandrashekhar Kulkarni, Consultant, Cardiovascular and Thoracic Surgery [CVTS] at the famed Global Hospital, Parel, Mumbai says that tobacco abstinence is essential in the therapies for Buerger’s disease. Failure to quit smoking is characterized by an increase in the risk of limb amputation. Other therapeutic interventions, such as anticoagulation and glucocorticoids, have no significant impact on Buerger’s disease.
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Buerger’s disease affects the small and medium arteries, as well as veins and nerves. Buerger disease is a nonatherosclerotic disease caused by inflammatory processes and thrombosis rather than atherosclerosis. Clinically, it most commonly manifests as digit ischemia and hand, arm, foot, or calf claudication. Ischemic ulcers are also possible. It almost always affects tobacco users, and the only true “treatment” is quitting smoking. A pathognomonic angiographic trying to find is the presence of “corkscrew” collaterals.
Dr Kulkarni further explains Berger’s disease is one of several types of vasculitis. This is an inflammation of the small and medium blood vessels. Buerger disease causes the blood vessels in your feet and hands to constrict or block. When blood flow to your hands and feet is restricted, particularly during activity, you may experience pain and tissue damage. In the worst-case scenario, sores (ulcers) form on your fingers and toes as a result of poor circulation to the skin and tissue. Ulcers can become infected and result in gangrene. Buerger disease decrease blood flow to the heart, abdomen, or brain in a small number of people.
What can cause Buerger’s disease?
Heavy smokers are at the highest risk of developing Buerger disease. It’s also been found in cigar smokers, marijuana users, and people who use smokeless tobacco like chewing tobacco and snuff. It is a rare disorder that poses less of a risk in countries where tobacco use has declined.
What are the signs and symptoms of Buerger’s disease?
Buerger disease symptoms include:
- Walking causes pain, soreness, or a burning sensation in your lower legs or feet.
- Soreness or pain in your hands or forearms
- Clots in the blood
- Ulcers on your fingers and toes
- Change in the colour of the skin on the fingers and toes to pale, reddish, and occasionally bluish
What is the treatment for Buerger’s disease?
The treatment you receive will be determined by your symptoms, age, and overall health. It will also depend on the severity of the condition. Buerger disease has no known cure. Treatment may be determined by the extent of your disease’s progression. It will try to increase blood flow to the affected area or reduce pain. Options include:
- Putting an end to all forms of tobacco use, which include electronic cigarettes.
- Operation to carry blood to the affected tissues
- Other surgeries to cut nerves to the tissue to relieve pain or cure damaged extremities
- Some medications help to relax blood vessels and increase blood flow to tissues.
Advanced treatment options
- Pain is a major problem for many people and in some, it even affects sleep.
In such patients
- Radio-frequency ablation of the pain pathway can lead to symptomatic relief of pain.
- Judicious use of a laser to heal the ulcers
- But in most cases amputation of the fingers/toes/limb is the only option to prevent pain and subsequent gangrene
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