Thromboangiitis obliterans, also known as Berger disease, affects the arms and legs with blood vessels. Symptoms include pain, tissue damage, and in severe cases, gangrene and amputation. As a result, it causes inflammation and clotting of small and medium-sized arteries and veins, reducing blood flow.
There is no clear cause of Buerger disease, but it is strongly associated with tobacco use. Smoking cigarettes, chewing tobacco, or using other forms of tobacco can cause damage to the blood vessel lining and trigger an abnormal immune response. It is possible that some people have a genetic predisposition to develop Buerger disease. Chronic gum disease, male gender, and age under 45 are also possible risk factors.
The symptoms of Buerger disease usually develop gradually and may vary depending on the location and severity of the blood vessel damage. Some common symptoms include:
Pain, tingling, or numbness in the fingers or toes
Changes in skin color, such as pale, red, or blue
Fingers or toes that turn white then blue when exposed to cold (Raynaud’s phenomenon)
Pain in the legs or arms that worsens with walking or exercise (claudication)
Sores or ulcers on the fingers or toes
Inflammation of a vein just below the skin (phlebitis)
Cold or numb hands or feet
Buerger disease can be diagnosed based on the medical history, physical examination, and excluding other conditions that can cause similar symptoms. Some tests to confirm or exclude other causes include:
Blood tests to check for infections, autoimmune diseases, or blood clotting disorders
Allen’s test to measure the blood flow to the hands
Angiogram to visualize the blood vessels using contrast dye and X-rays
Doppler ultrasound to assess the blood flow and detect blockages
Biopsy to examine a sample of the affected tissue under a microscope
A key treatment for Buerger disease is quitting all forms of tobacco use, which can improve symptoms and prevent the progression of the disease. There are a number of treatments available to manage the condition and reduce the risk of complications, including medications, procedures, and self-care measures.
Medications such as vasodilators, anti-inflammatory drugs, or antibiotics to improve blood flow, reduce inflammation, or treat infections
Procedures such as surgical sympathectomy, debridement, or amputation to cut the nerves that control blood vessel constriction, remove dead tissue, or remove severely damaged fingers or toes
Self-care measures such as drinking plenty of fluids, staying active, avoiding cold exposure, wearing comfortable shoes, and taking care of the skin and nails
If you are a smoker, quit as soon as possible to reduce your risk of developing or worsening Buerger disease. If you are a smoker, quit as soon as possible. Maintaining good oral hygiene, controlling other medical conditions, such as diabetes and high blood pressure, and maintaining a healthy lifestyle can also help reduce your risk.
