Buerger disease, or thromboangiitis obliterans, is rare disorder related to smoking, and it is most commonly found in men who are 20 to 40 years old. The disease causes pain and swelling of the small and medium-sized arteries (and veins) in the hands and feet. Smoking generally constricts all blood vessels, but the level of tightening is so great in patients with Buerger disease that it cuts off oxygen to the cells, causing pain and eventual tissue death.
The symptoms differ, but may include painful or tender, reddened, swollen blood vessels, cold feet and hands, and leg pain while walking (intermittent claudication). Pulses may be weak or absent in the hands or feet.
Diagnostic tests that may be used to determine whether or not the blood vessels in the hands or feet are blocked may include angiography, arteriography, and Doppler ultrasound. Final confirmation of the diagnosis may require a biopsy of the blood vessel.
Because no cure has been found for Buerger disease, the treatment is smoking cessation, which usually restores circulation. The most serious cases cause tissue death (gangrene), where amputation of the fingers or toes may be needed.
Texas Heart Institute www.texasheartinstitute.com/HIC/Topics/Cond/pvd.cfm
Medline Plus www.nlm.nih.gov/medlineplus/ency/article/000172.htm