BUERGERS-DISEASE - (THROMBOANGIITIS-OBLIT ERANS)

Thromboangiitis obliterans is an inflammatory disease affecting chiefl y the small and medium-sized peripheral arteries and veins. Cigarettes are used moderately or excessively by many patients suffering from th is disease. Thromboangiitis appears to be more common in males than in females (male:female = 3:1). Both, peripheral vascular ischemia and t hrombophlebitis migrans are typical symptoms of this disease. Raynaud' s phenomenon, hyperhidrosis, and ulcers of the digits are common. Arte riography can be helpful in demonstrating specific vascular lesions, i .e. multiple, focal segments of stenosis and/or occlusion and vast col lateral circulation. Symptoms and signs of peripheral vascular disease comparable to Buerger's disease may also appear in arteriosclerosis, hypersensitivity angiitis, Wegener's granulomatosis, polyarteritis nod osa, rheumatoid arthritis and collagen diseases. It is an imperative i n Buerger's disease that tobacco never be used in any form. During the acute stage of thromboangiitis obliterans, treatment with acetylsalic ylic acid (3 g/day) or corticosteroids (minimum 30 mg/day) is proposed . Severe ischemia of the legs and arms should be treated with prostagl andin E(1)(2 x 40 mu g PGE(1)/day). The prognosis of Buerger's disease for life is good but amputations of extremities are common. The risk of amputation decreases if there is a strict abstinence from tobacco. 10-year-survival rate accounts 94%.