What is Buerger’s Disease?

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What is the meaning of Buerger’s Disease?

Buerger’s disease, also known as thromboangiitis obliterans, is a rare condition that inflames and blocks the blood vessels (arteries and veins) in the arms and legs. The blockage of blood vessels leads to the stoppage of the flow of blood and blood clot (masses of blood) formation in the hands and feet.  Buerger’s disease eventually damages or destroys the skin tissues and can cause infection and gangrene (dead tissue) in the hands and feet. Tobacco consumption is the primary cause of Buerger’s disease. Quitting all the forms of tobacco is the only method of stopping Buerger’s disease. If an individual fails to quit tobacco, amputation of a part or whole of the limb becomes necessary.

In this article, we will be discussing in detail Buerger’s disease.

• What are the causes of Buerger’s Disease?
• What are the risk factors for Buerger’s Disease?
• What are the symptoms of Buerger’s Disease?
• How to diagnose Buerger’s Disease?
• What is the treatment for Buerger’s Disease?
• What are the complications of Buerger’s Disease?
• How to prevent Buerger’s Disease?

What are the causes of Buerger’s Disease?

• The exact cause of Buerger’s disease is not known.
• Tobacco plays a role in the development of Buerger’s disease. However, it is not clear how it causes the disease.
• The chemicals in tobacco may cause irritation to the blood vessel lining, causing them to swell.
• Some theories suggest that some genetic factors may cause the condition.
• Some other theories suggest that it is an autoimmune condition, that is, the body’s immune system or disease-fighting system attacks the body’s healthy tissues. ( Know more about- What is Thrombophlebitis? )

What are the risk factors for Buerger’s Disease?

Certain factors may increase the risk of developing Buerger’s disease. These factors include:

• Smoking
• Age between 20 years and 45 years
• More common in males
• Chronic or long-term gum diseases ( Know more about- What are the home remedies to strengthen gums ? )
• Asian and East European race

What are the symptoms of Buerger’s Disease?

The symptoms of Buerger’s disease are:

• Numbness or tingling in the feet or hands
• Reddish, or blue feet or hands
• Pale feet or hands
• Cold feet or hands
• Pain at rest
• Pain on doing some activity, which becomes less on stopping the activity
• Raynaud’s phenomenon (toes and fingers turn pale on exposure to cold)
• Inflammation along a vein just below the surface of the skin (because of a blood clot in the vein)
• Painful open sores or ulcers on the toes and fingers ( Know more about- What is a Diabetic foot ulcer ? )

How to diagnose Buerger’s Disease?

• Physical examination: The patient is examined physically. The medical history and symptoms of the patient are noted. The pulses in the hands, forearms, lower parts of the feet, and legs may be absent in case of Buerger’s disease. However, the pulses in the upper portions of the upper and lower limbs are normal.
• Blood tests: These tests are done to rule out other conditions that could be causing the symptoms, like diabetes or other auto-immune diseases.
• Imaging tests: Imaging tests like computed tomography angiography (CTA), magnetic resonance angiography (MRA), and conventional arteriography may be performed to check the patency of the blood vessels. These tests should be performed on all four limbs. In the case of Buerger’s disease, the angiograms may show the following:
• Localized blockage areas in small and medium sized-blood vessels
• Development of collateral blood circulation (alternate circulation around a blocked artery or vein) around the occluded portions of the blood vessels
• Atherosclerosis (build-up of fat, cholesterol, and other substances in and around the artery walls) is absent in the affected blood vessels 
• The Allen test: This is a type of blood flow test. The patient is first asked to squeeze his/her hand into a hard fist, to push the blood out of the hand. The doctor then presses on the wrist arteries to slow the blood flow back into the patient’s hand. The hand starts losing its clot at this point. When the patient opens his/her hand, the doctor releases the pressure over the wrist artery on one side and then on the other side. If it takes considerable time for the hand to go back to its normal color, it could indicate the presence of Buerger’s disease.
• Angiogram: This is a kind of x-ray done to check for blocked blood vessels in the arms and legs. A thin tube, known as a catheter is placed by the doctor into the artery. A dye is injected into the artery and x-rays are taken to obtain clear images of the blood vessels. ( Know more about- What is Peripheral Angiography? )
• Echocardiogram (ECG): Sound waves are used to obtain images of the heart in motion. It may be recommended to check that blood clots do not arise in the heart region. ( Know more about- What is Echocardiography? )
• Biopsy: The doctor removes a small part of the affected vessel and sends it to the laboratory to confirm the diagnosis of Buerger’s disease.

What is the treatment for Buerger’s Disease?

There is no specific line of treatment for Buerger’s disease. The patient is advised to quit smoking to reduce the risk of amputation.

Some of the treatment options may include:

• Medications: Some medications may help in relieving the symptoms of Buerger’s disease. However, these medications do not treat the condition. Some of the medications that are prescribed include:
• Antiplatelet drugs: Drugs like aspirin and clopidogrel help in preventing blood clot formation.
• Calcium channel blockers: Medications like verapamil help in increasing the oxygen supply to the affected part.
• Cilostazol: It helps in preventing blood clotting and relaxes the blood vessels. 
• Pentoxifylline: It reduces the viscosity of blood and improves the blood flow through the blood vessels which have narrowed.
• Antibiotics: These medications are used to treat ulcers that are infected.
• Surgery: The following surgical procedures are advised for treating Buerger’s disease:
• Local debridement: The gangrenous area is treated by the removal of the dead or infected skin tissue.
• Amputation: Removal of a limb may be required if the gangrenous area cannot be removed by debridement alone.
• Surgical revascularization: It is a procedure of increasing the blood supply to the blood-deprived area, but is not very effective.
• Sympathectomy: It is the procedure of cutting the nerves constricting the blood vessels. It helps in increasing the flow of blood to the affected area.
• Spinal cord stimulators: They are used to reduce the pain and increase the supply of blood to the affected limb.
• Ilizavor’s technique: A gradual tension is applied to the tissue for promoting growth and regeneration. ( Know more about- What is Mohs Surgery? )

What are the complications of Buerger’s Disease?

The complications associated with Buerger’s disease are:

• Gangrene (the skin and tissue in the toes and fingers start to die, go numb, and may turn blue or black due to stoppage of blood flow)
• Amputation (cutting off the area affected by gangrene)
• Heart attack ( Know more about- What is Heart Attack ? )
• Stroke (blood supply to the brain is interrupted)
• Transient ischemic attack (when the blood supply to the brain is stopped for a short time)
• Problems with the blood vessels in the intestine
• Problems with the nervous system (brain and spinal cord) ( Know more about- What is Coccydynia?( Tailbone pain ) ? )

How to prevent Buerger’s Disease?

Buerger’s disease can be prevented in the following ways:

• Quit smoking ( Know more about- Home remedies to quit smoking ? )
• Avoid chewing tobacco
• Avoid exposure to second-hand smoke
• Avoid medicines that increase the risk of blood clotting or cause the blood vessels to tighten
• In case of an affected arm or leg, protect it from any injury by wearing proper shoes
• Avoid exposure to cold air 

We hope we could answer all your questions about Buerger’s Disease through this article.

If you want to get more information and treatment about Buerger’s disease, you can contact an Endo-Vascular Surgeon.

We only aim to give you information through the article. We do not recommend medication or treatment in any way. Only a doctor can give you good advice because no one else is better than them.