Distal ischemia with digital gangrene secondary to Buerger's disease

Thromboangitis obliterans, or Buerger's disease, is a progressive vascular disorder that affects the distal extremities of young, otherwise healthy patients. The authors present two case histories of Buerger's disease with spontaneous digital ischemia and gangrene, leading ultimately to digital amputation. A review of the literature is also presented. The natural history of Buerger's disease, current diagnostic techniques, and management of these patients are discussed with emphasis on prevention of the acute attack and long-term sequelae.