Buerger Disease and Smoking: Vascular Disease in Young Smokers

Buerger disease (thromboangiitis obliterans) is a disease in which small and medium-sized vessels of the arms and legs become inflamed and blocked. Unlike other vascular diseases it is seen mainly in young and middle-aged smokers, especially men.

Symptoms include cold hands and feet, color changes (white, purple), pain in the sole or calf when walking, pain at rest, sores on the fingertips and toes that do not heal and, in advanced stages, blackening or gangrene. Symptoms can worsen in the cold.

Diagnosis is made by examination, vascular ultrasound and angiography; other diseases with similar symptoms (diabetes, rheumatic diseases, cholesterol-related vascular disease) are excluded.

The foundation of treatment is to stop smoking and all tobacco products completely. When smoking stops the disease halts or slows in most patients; if smoking continues the risk of amputation rises markedly. Support for quitting is therefore an integral part of treatment.

Because the vessels are very thin and blocked over long segments, opening them with balloons and stents is not always possible in these patients. In carefully selected patients catheter intervention on the foot arteries can be tried; wound care, medication and pain control are carried out together. The decision is made with the vascular team according to the vessel imaging.

If you are a young smoker and notice cold feet, pain or a wound that does not heal, see a specialist. This article is general information; diagnosis requires an examination.