[Buerger's disease]

Buerger's disease (Thromboangiitis obliterans--TAO) is a nonatherosclerotic, segmental inflammatory disease that most frequently affects the small and medium-sized arteries and veins in the upper and lower extremities. There exists an extremely strong association between heavy tobacco use and TAO. The histopathology of the involved blood vessels varies according to the chronologic stage of the disease at which the tissue sample is obtained for examination. The histopathology is most likely to be diagnostic at the acute phase of the disease. Buerger's disease typically occurs in young male smokers, with the onset of symptoms before the age of 40 to 45 years. Several published series have shown an increasing prevalence of the disease in women. There is little information on the use of intra-arterial thrombolytic therapy, prostaglandin therapy, or angiogenesis. Discontinuation of tobacco use is the mainstay of treatment. Patients who successfully stop smoking almost never need amputation.