Thromboangiitis obliterans, also known as Buerger's disease, is a type of vascular disorder that causes clotting in the blood vessels of the hands, arms, feet, and legs. Decreased blood flow can lead to the presence of ischemic ulcers, pain, and eventually gangrene in the extremities. It is a rare disorder that arises from long-term, heavy tobacco use. When the disorder is detected early, simply quitting smoking is usually enough to stop the progression of thromboangiitis obliterans. Surgery is necessary when the disease is in its later stages to repair damaged blood vessels and surrounding tissue.
Doctors and medical researchers do not fully understand why thromboangiitis obliterans occurs, but they do know how it develops. Experts have discovered that using large amounts of tobacco over a long period of time can lead to swelling and inflammation in the blood vessels of the hands and feet. As vessels in the extremities swell, blood flow becomes severely restricted. Clotting occurs over time, and blood flow problems tend to worsen if an individual continues to smoke or chew tobacco.
A person who has thromboangiitis obliterans is likely to experience pain and weakness in the hands or feet. Extremities may swell, turn pale, and lose feeling over time. Discolored ulcers and open sores appear as blood flow becomes more and more restricted. Tissue in the fingers and toes eventually begins to die and rot as it stops receiving sufficient amounts of oxygen, a condition known as gangrene.
A doctor who suspects thromboangiitis obliterans usually performs several diagnostic tests to rule out other conditions that cause blood clotting, such as atherosclerosis, diabetes, and congenital disorders. The physician can collect blood and urine samples and perform an arteriography, a special type of x-ray procedure that reveals clots and blood vessel damage. After confirming a diagnosis, the physician can determine the best course of treatment.
Patients who are diagnosed with thromboangiitis obliterans do not usually need to take medications or undergo surgery. Instead, the condition tends to be relieved when patients abstain from tobacco, avoid exposure to cold, and exercise their hands and feet regularly. If blood circulation does not return, a patient may be prescribed drugs to relax and open blood vessels. When the disease progresses enough to cause numbness and tissue death, a surgeon can try to relieve problems by manually opening vessels and clearing away clots. Amputation is necessary only when gangrene has destroyed an extremity beyond repair.