Buerger's disease - Diagnosis and treatment (2023)

Diagnosis

While no tests can confirm whether you have Buerger's disease, your doctor will likely order tests to rule out other more common conditions or confirm suspicion of Buerger's disease brought on by your signs and symptoms. Tests may include:

Blood tests

Blood tests to look for certain substances can rule out other conditions that may cause similar signs and symptoms. For instance, blood tests can help rule out autoimmune diseases such as scleroderma or lupus, blood-clotting disorders, and diabetes.

The Allen's test

Your doctor may perform a simple test called the Allen's test to check blood flow through the arteries carrying blood to your hands. In the Allen's test, you make a tight fist, which forces the blood out of your hand. Your doctor presses on the arteries at each side of your wrist to slow the flow of blood back into your hand, making your hand lose its normal color.

Next, you open your hand and your doctor releases the pressure on one artery, then the other. How quickly the color returns to your hand may give a general indication about the health of your arteries. Slow blood flow into your hand may indicate a problem, such as Buerger's disease.

Angiogram

An angiogram helps to see the condition of your arteries. An angiogram can be done non-invasively with the use of CT or MRI scans.

(Video) Understanding Buerger Disease (Thromboangiitis Obliterans)

Or it may be done by threading a catheter into an artery. During this procedure, a special dye is injected into the artery, after which you undergo a series of rapid X-rays. The dye helps make any artery blockages easier to see on the images.

Your doctor may order angiograms of both your arms and your legs — even if you don't have signs and symptoms of Buerger's disease in all of your limbs. Buerger's disease almost always affects more than one limb, so even though you may not have signs and symptoms in your other limbs, this test may detect early signs of vessel damage.

Care at Mayo Clinic

Our caring team of Mayo Clinic experts can help you with your Buerger's disease-related health concernsStart Here

Treatment

Smoking cessation

Although no treatment can cure Buerger's disease, the most effective way to stop the disease from getting worse is to quit using all tobacco products. Even a few cigarettes a day can worsen the disease.

(Video) Buerger disease | Circulatory System and Disease | NCLEX-RN | Khan Academy

Your doctor can counsel you and recommend medications to help you stop smoking and stop the swelling in your blood vessels. You'll need to avoid nicotine replacement products because they supply nicotine, which activates Buerger's disease. There are non-nicotine products that you can use.

Another option is a residential smoking cessation program. In these programs, you stay at a treatment facility, sometimes a hospital, for a set number of days or weeks. During that time you participate in daily counseling sessions and other activities to help you deal with the cravings for cigarettes and to help you learn to live tobacco-free.

Other treatments

Other treatment approaches exist for Buerger's disease, but are less effective than quitting smoking. Options include:

  • Medications to dilate blood vessels, improve blood flow or dissolve blood clots
  • Intermittent compression of the arms and legs to increase blood flow to your extremities
  • Spinal cord stimulation
  • Amputation, if infection or gangrene occurs

Potential future treatments

  • Nerve surgery. Surgery to cut the nerves to the affected area (surgical sympathectomy) to control pain and increase blood flow, although this procedure is controversial and long-term results haven't been well-studied
  • Growing new blood vessels. Medications to stimulate growth of new blood vessels (therapeutic angiogenesis), an approach that is considered experimental
  • Bosentan (Tracleer). This medication has been approved for treating high blood pressure in the lungs. The drug improved blood flow in small studies of people with Buerger's disease.
  • Blood vessel procedure. A thin catheter threaded into the blood vessels might open blood vessels, restoring blood flow. Although this procedure — called endovascular therapy — isn't widely used, it might be effective.

Request an Appointment at Mayo Clinic

(Video) Buerger's Disease and Raynaud's - Medical-Surgical (Med-Surg) - Cardiovascular System - @Level Up RN

Lifestyle and home remedies

There are a number of things you can do on your own to help improve your symptoms, such as:

  • Exercise. Getting regular physical activity can benefit you in a number of ways, including helping to ease some of the pain of Buerger's disease. Try to get at least 30 minutes of moderate aerobic activity, such as walking or biking, most days of the week.
  • Skin care. Take care of your fingers and toes if you have Buerger's disease. Check the skin on your arms and legs daily for cuts and scrapes, keeping in mind that if you've lost feeling to a finger or toe you may not feel, for example, a cut when it happens. Keep your fingers and toes protected and avoid exposing them to cold.
  • Infection prevention. Low blood flow to your extremities means your body can't resist infection as easily. Small cuts and scrapes can easily turn into serious infections.

    Clean any cut with soap and water, apply antibiotic ointment, and cover it with a clean bandage. Keep an eye on any cuts or scrapes to make sure they're healing. If they get worse or heal slowly, see your doctor promptly.

  • Gum care. Visit your dentist regularly to keep your gums and teeth in good health and avoid gum disease, which in its chronic form is linked to Buerger's disease.
  • Avoiding other people's smoke. In addition to not smoking yourself, it's important to avoid secondhand smoke too.

Preparing for your appointment

You're likely to start by seeing your family doctor or primary care provider, who may eventually refer you to someone who specializes in blood vessel diseases (vascular specialist).

What you can do

To make the most of your appointment, come prepared with information and questions for your doctor.

(Video) Why is Buerger Disease occurs more often in smokers than non-smokers? How can we treat it?

  • Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
  • Write down key personal information, including whether you've ever smoked, and how many packs a day, or if you're exposed to trauma to your hands or feet, such as from using a jackhammer or other vibrating tools.
  • Make a list of all medications, as well as any vitamins or supplements, that you're taking.
  • Take a family member or friend along, if possible. Sometimes it can be difficult to remember all the information provided to you during an appointment. Someone who accompanies you may remember something that you missed or forgot.
  • Write down questions to ask your doctor.

Some basic questions to ask your doctor include:

  • What's the most likely cause of my symptoms?
  • Are there other possible causes for my symptoms?
  • What kinds of tests do I need?
  • Is my condition likely temporary or long-lasting?
  • What treatment options are available, and which do you recommend?
  • I have these other health conditions. How can I best manage these conditions together?
  • Are there any restrictions that I need to follow?
  • Should I see a specialist?
  • Are there any brochures or other printed material that I can take home with me? What websites do you recommend visiting?

In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment.

What to expect from your doctor

Your doctor may ask:

  • When did you begin experiencing symptoms?
  • Do you have symptoms all the time, or do they come and go?
  • How severe are your symptoms?
  • Does anything seem to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
  • Do you use tobacco in any form now or have you ever used it?
  • Do your fingers change color in response to cold?
  • Have you had repetitive trauma to the affected area from tools?

FAQs

How is Buerger's disease diagnosed? ›

Buerger's disease diagnostic tests may include: A complete physical exam that checks your pulse. Ultrasound — uses sound waves to create pictures of the blood flow through your arms and legs. Angiogram — uses an x-ray and contrast material to show blockages in your blood vessels.

How is thromboangiitis obliterans diagnosed? ›

There are no blood tests that diagnose thromboangiitis obliterans. A heart echocardiogram may be done to look for sources of blood clots. In rare cases when the diagnosis is unclear, a biopsy of the blood vessel is done.

What is a positive Buerger's test? ›

Buerger's test is a useful adjunct to routine peripheral vascular assessment and, if positive, suggests more severe ischaemia with distal limb artery involvement.

Which is a common problem associated with Buerger disease? ›

In severe cases, individuals with Buerger's disease may exhibit tissue death (gangrene) of the affected areas. In some cases, arteries and veins of the intestines may also be affected. This may result in extreme heaviness or pain (angina) in the abdomen and weight loss.

Which specialist treats Buerger's disease? ›

If you have any of the symptoms above, talk to your primary care doctor. If your doctor suspects Buerger's disease, you may benefit from the expertise of a rheumatologist.

Is Buerger's disease permanent? ›

There's no cure for Buerger's disease. Almost everyone who gets it uses tobacco, including cigarettes, cigars, chewing tobacco, and snuff. Quitting can make the symptoms improve or go away completely. If you don't quit, you might have severe tissue damage.

Is Buerger's disease autoimmune? ›

The cause of Buerger's disease is not known, but scientists think something in tobacco hurts the lining in your blood vessels. Most people with Buerger's disease are tobacco users. Your genes may make you more likely to get Buerger's disease. Some scientists think it's an autoimmune disease.

What causes Buerger's disease? ›

The exact cause of Buerger's disease is unknown, however tobacco use is strongly linked to its development. Researchers believe that chemicals in tobacco may irritate the lining of the blood vessels, causing them to swell.

What are the 3 common complications of thromboangiitis obliterans? ›

Possible Complications
  • Tissue death (gangrene)
  • Amputation of fingers or toes.
  • Loss of blood flow in the limb of the affected fingers or toes.
3 Aug 2020

What is Buerger's exercise? ›

Buerger-Allen Exercise (BAE) is one of the types of exercise performed to promote Lower Extremity Perfusion (LEP) whereby promoting the wound healing process and reduce Peripheral Neuropathy Symptoms (PNS) among Diabetes Mellitus (DM) patients.

Is Buerger's disease progressive? ›

Buerger disease is a nonatherosclerotic, progressive, segmental inflammatory disease affecting the small and medium-sized arteries of upper and lower limbs.

Can Buerger's disease affect the brain? ›

In the worst cases, sores (ulcers) appear on your fingers and toes due to poor circulation to the skin and tissue. The ulcers can become infected and cause gangrene. In a small number of people, Buerger disease reduces blood flow to the heart, belly, or brain.

What is the difference between Raynaud's and Buerger's disease? ›

Raynaud's is a condition where the extremities of the hands and feet turn white when exposed to cold. A common sign in Buerger's is skin ulceration and gangrene of the fingers and toes.

Can you reverse Buerger's disease? ›

Sir, Buerger's disease is a distinct pathological entity and disease progression can be reversed by cessation of smoking. Although classically affecting the lower limbs, patients with Buerger's disease may present with non‐specific rheumatic symptoms or isolated upper limb vasculitis.

What is similar to Buerger's disease? ›

Diseases with which Buerger's Disease may be confused include atherosclerosis (build–up of cholesterol plaques in the arteries), endocarditis (an infection of the lining of the heart), other types of vasculitis, severe Raynaud's phenomenon associated with connective tissue disorders (e.g., lupus or scleroderma), ...

How do you test for arterial insufficiency? ›

Angiography. This test uses X-rays, magnetic resonance imaging (MRI) scans or computerized tomography (CT) scans to look for blockages in the arteries. Before the images are taken, dye (contrast) is injected into a blood vessel. The dye helps the arteries show up more clearly on the test images.

What are smokers legs? ›

Smoker's leg is the term for PAD that affects the lower limbs, causing leg pain and cramping. The condition results from the buildup of plaque in the arteries and, in rare cases, the development of blood clots.

Does alcohol affect Buerger's disease? ›

Abstract. Alcohol ingestion is considered as a possible pathogenic agent for Berger's disease, since Iga mesangial deposits have been described in liver cirrhosis.

How do you control Thromboangiitis obliterans? ›

Thromboangiitis Obliterans (Buerger Disease) Treatment &...
  1. Approach Considerations.
  2. Cessation of Tobacco Use.
  3. Pharmacologic Therapy.
  4. Hyperbaric Oxygen Therapy.
  5. Surgical and Endovascular Intervention.
  6. Prevention.
  7. Consultations.
22 Jul 2022

Can you lose toes from smoking? ›

If the patient continues poor lifestyle habits, like smoking, PAD slowly starves the toes, feet and legs (peripheral parts of the body) of oxygen, which can lead to gangrene and amputation if not treated.

Who discovered Buerger's disease? ›

Buerger's disease was first discovered by Felix Von Winiwater, a German physician, in 1879. It was described in detail by Leo Buerger in 1908 in New York,who called it presenile spontaneous gangrene after studying amputations in 11 patients.

What causes hands to turn black? ›

Cold temperatures, circulation problems, and tight jewelry are common causes. Often, cyanosis is not serious. However, some underlying causes are. A person should seek medical attention if they develop the symptoms.

Can nicotine gum cause Buerger's disease? ›

Smoking Cessation

Even smoking as little as one or two cigarettes a day can worsen the disease. Transdermal nicotine patches and nicotine chewing gum should also be avoided because they can contribute to disease activity.

What are 10 diseases caused by smoking? ›

Smoking causes cancer, heart disease, stroke, lung diseases, diabetes, and chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis. Smoking also increases risk for tuberculosis, certain eye diseases, and problems of the immune system, including rheumatoid arthritis.

What does smokers leg look like? ›

The smoker's leg exhibits a livid-black discoloration of the skin in the affected areas (dry gangrene). The alterations begin mostly in the periphery of the foot (toes) and then continue to proximal.

Can smoking leg be reversed? ›

Findings indicate that smoking cessation can reverse arterial stiffening and pressure augmentation.

How common is thromboangiitis obliterans? ›

The annual incidence of thromboangiitis obliterans is reported to be 12.6 per 100 000 in the United States. Although it is observed worldwide, thromboangiitis obliterans is more prevalent in the Middle East and Far East.

What is vasculitis of the legs? ›

Vasculitis is a general term used to describe a disease that leads to inflammation of blood vessels. When the blood vessels of your legs become inflamed, this is called vasculitis of the legs. The blood vessels in your legs start to weaken and can either grow or shrink in size.

What is Takayasu arteritis? ›

Takayasu's arteritis (tah-kah-YAH-sooz ahr-tuh-RIE-tis) is a rare type of vasculitis, a group of disorders that causes blood vessel inflammation. In Takayasu's arteritis, the inflammation damages the large artery that carries blood from your heart to the rest of your body (aorta) and its main branches.

What exercise helps varicose veins? ›

What Exercises Prevent Varicose Veins?
  1. Walking or Running. Walking just 30 minutes a day for five days a week can yield good benefits. ...
  2. Leg Lifts. You need to do this move regularly to see the benefits. ...
  3. Bicycling or Bicycle Legs. Riding a bike or stationary bike is also helpful. ...
  4. Lunges. ...
  5. Rocking Your Feet. ...
  6. Standing Calf Raises.
10 Dec 2020

How do you do the Buerger Allen exercise? ›

Buerger-Allen Exercise - YouTube

What is Buerger Allen? ›

Buerger's exercise or Buerger-Allen exercises (BAE) was published for the first time by Leo Buerger in 1924 then modified by Arthur Allen to be a postural treatment option that is low cost and effective with low risk, for patients with lower limb arterial insufficiency.

What causes toes to turn white? ›

Raynaud's disease causes smaller arteries that supply blood flow to the skin to narrow in response to cold or stress. The affected body parts, usually fingers and toes, might turn white or blue and feel cold and numb until blood flow improves, usually when you get warm.

Is Buerger's disease pad? ›

Buerger's disease, which occurs almost exclusively in heavy smokers, is different from peripheral arterial disease (PAD) in that it is not caused by atherosclerosis (plaque buildup in the arteries). The disease can cause pain in the hands and feet in response to exercise due to reduced blood-flow.

What is the difference between Raynaud's and Buerger's disease? ›

Raynaud's is a condition where the extremities of the hands and feet turn white when exposed to cold. A common sign in Buerger's is skin ulceration and gangrene of the fingers and toes.

What kind of doctor treats Buerger's disease? ›

If you have any of the symptoms above, talk to your primary care doctor. If your doctor suspects Buerger's disease, you may benefit from the expertise of a rheumatologist.

What causes Berger's disease? ›

IgA nephropathy (nuh-FROP-uh-thee), also known as Berger's disease, is a kidney disease that occurs when an antibody called immunoglobulin A (IgA) builds up in your kidneys. This results in local inflammation that, over time, can hamper your kidneys' ability to filter waste from your blood.

Can Buerger's disease affect the brain? ›

In the worst cases, sores (ulcers) appear on your fingers and toes due to poor circulation to the skin and tissue. The ulcers can become infected and cause gangrene. In a small number of people, Buerger disease reduces blood flow to the heart, belly, or brain.

Is Buerger's disease autoimmune? ›

The cause of Buerger's disease is not known, but scientists think something in tobacco hurts the lining in your blood vessels. Most people with Buerger's disease are tobacco users. Your genes may make you more likely to get Buerger's disease. Some scientists think it's an autoimmune disease.

Is Buerger's disease progressive? ›

Buerger disease is a nonatherosclerotic, progressive, segmental inflammatory disease affecting the small and medium-sized arteries of upper and lower limbs.

What is Buerger's exercise? ›

Buerger-Allen Exercise (BAE) is one of the types of exercise performed to promote Lower Extremity Perfusion (LEP) whereby promoting the wound healing process and reduce Peripheral Neuropathy Symptoms (PNS) among Diabetes Mellitus (DM) patients.

Can you reverse Buerger's disease? ›

Sir, Buerger's disease is a distinct pathological entity and disease progression can be reversed by cessation of smoking. Although classically affecting the lower limbs, patients with Buerger's disease may present with non‐specific rheumatic symptoms or isolated upper limb vasculitis.

Is Buerger's disease a disability? ›

While Buerger's Disease isn't specifically listed in the SSA blue book, many of the symptoms of the disease are conditions that are listed as disorders that are covered. People who are unsure if they have the disease or if they're eligible for disability benefits should read more about the disease below.

Does alcohol affect Buerger's disease? ›

Abstract. Alcohol ingestion is considered as a possible pathogenic agent for Berger's disease, since Iga mesangial deposits have been described in liver cirrhosis.

How long can you live with Bergers disease? ›

For most people, the disease progresses very slowly. Up to 70 percent of people can expect to have a normal life expectancy without complications. This is especially true for people who only have minimal proteinuria and normal kidney function at the time of their diagnosis.

What are the 5 symptoms of hemolytic uremic syndrome? ›

What are the symptoms of hemolytic uremic syndrome? Symptoms of HUS include vomiting, bloody diarrhea (loose stool/poop), stomach pain, fever, chills, and headache. As infection progresses, persons may experience fatigue, weakness, fainting, bruising, and paleness.

What foods to avoid when you have IgA nephropathy? ›

17 Foods to Avoid or Limit If You Have Bad Kidneys
  • Diet and kidney disease. Copyright: knape. ...
  • Dark-colored soda. In addition to the calories and sugar that sodas provide, they harbor additives that contain phosphorus, especially dark-colored sodas. ...
  • Avocados. ...
  • Canned foods. ...
  • Whole wheat bread. ...
  • Brown rice. ...
  • Bananas. ...
  • Dairy.

Who discovered Buerger's disease? ›

Buerger's disease was first discovered by Felix Von Winiwater, a German physician, in 1879. It was described in detail by Leo Buerger in 1908 in New York,who called it presenile spontaneous gangrene after studying amputations in 11 patients.

What causes toes to turn white? ›

Raynaud's disease causes smaller arteries that supply blood flow to the skin to narrow in response to cold or stress. The affected body parts, usually fingers and toes, might turn white or blue and feel cold and numb until blood flow improves, usually when you get warm.

Videos

1. Buerger's disease | Symptoms | Causes | Treatment | Diagnosis aptyou.in
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2. A Patient (NOT) with Buerger's Disease
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3. Peripheral Blood Vessel Disorders - Buerger's Disease
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4. Buerger's Test
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5. RARE DISEASE EP5 - Buerger's disease
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6. Buerger's Disease || Case Demonstration || Dr. Shankar Dey
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