Howarth Wood Darwen Buerger

Buerger Disease

Buerger disease, also know thromboangiitis obliterans (TAO) is a progressive, nonatherosclerotic, segmental, inflammatory disease that most often affects small and medium arteries of the upper and lower extremities. The typical age range for occurrence is 20 to 50 years, and the disorder is more frequently found in males who smoke. Migratory superficial phlebitis can be present in up to 16% of patients and indicates a systemic inflammatory response.

Patients initially present with foot, leg, arm, or hand claudication which may be mistaken for joint or neuromuscular problems. Progression of the disease leads to calf claudication, and eventually, ischemic rest pain and ulcerations on the toes, feet, or fingers. This is also called Raynaud's.

The treatment of TAO revolves around strict smoking cessation. In patients who can abstain, disease remission is impressive, and amputation avoidance is increased. The role of surgical intervention is minimal in Buerger’s disease as there is often no acceptable target vessel for bypass. Furthermore, autogenous vein conduits are limited secondary to coexisting migratory thrombophlebitis.