Buerger

1
BuergersDisease

• A presentation by Jennifer Kent-Baker

2
Buergers Disease What It Is

• Buerger's disease (thromboangiitis obliterans)
  is a rare disease characterized by a combination
  of acute inflammation and thrombosis of the
  arteries and veins in the hands and feet. The
  obstruction of blood vessels in the hands and
  feet reduces the availability of blood to the
  tissues, causes pain and eventually damages or
  destroys the tissue. It often leads skin
  ulcerations and gangrene of fingers and toes.
  Rarely, in advanced stages of the disease, it may
  affect vessels in other parts of the body.

3
Buergers Disease Appearance

• Ulcers and Gangrene caused by Buergers Disease

4
Buergers Disease Who It Affects

• Buerger's disease affects approximately six out
  of every 10,000 people. It almost always affects
  men, ages 20 to 40, who smoke or chew tobacco.
  Recently, however, more women and men over the
  age of 50 have been diagnosed with Buerger's
  disease. This disorder is still very uncommon in
  children, but it may occur in those with
  autoimmune diseases. Buerger's disease is most
  common in the Orient, Southeast Asia, India and
  the Middle East, but is rare among
  African-Americans.

5
Buergers Disease Symptoms

• Enlarged, red, tender cord-like veins
• Pain or tenderness
• Numbness and tingling in the limbs
• Skin ulcers or gangrene of the digits
• Discoloration
• Two or more limbs affected
• Pain may increase with activity such as walking
  and decrease with rest
• Pulse may be decreased or absent in the affected
  extremity
• Symptoms may worsen with exposure to cold or with
  emotional stress

6
Buergers Disease The Cause

• Buerger's disease is greatly associated with
  heavy to moderate tobacco use, both cigarette and
  smokeless. The disease is an autoimmune reaction
  triggered by tobacco.

7
Buergers Disease Diagnosing

• Buerger's disease is often masked by a wide
  variety of other diseases that cause diminished
  blood flow to the hands and feet, therefore,
  other disorders must be ruled out with aggressive
  evaluation.
• Blockage of blood vessels in the hands and feet
  caused by Buerger's disease may be detected by
  one of the following methods
• An angiogram or an arteriogram of the upper and
  lower extremities
• A Doppler ultrasound
• Skin biopsies are rarely used because of concern
  that the biopsy site near an area with poor blood
  circulation will not heal.

8
Normal and Abnormal Angiograms
9
Buergers Disease Angiogram

• Angiogram of the Hand

Normal
In Buergers Disease
10
Buergers Disease Prevention

• To avoid the onset of Buerger's disease, tobacco
  use should be avoided, particularly by men.

11
Buergers Disease Treatment

• The only method known to be an effective
  treatment for Buerger's disease is immediately
  quitting smoking. Patients who continue to smoke
  after a diagnosis of Buerger's disease will
  generally require amputation of the fingers and
  toes.
• Since there is no cure for Buerger's disease, the
  goal of treatment is to control symptoms.

12
Buergers Disease Symptom Control

• Gentle massage and warmth to increase circulation
  
• Avoid conditions that reduce circulation to the
  extremities
• Avoid sitting or standing in one position for
  long periods
• Do not walk barefoot to avoid injury
• Do not wear tight or restrictive clothing
• Report all injuries to physician for appropriate
  treatment

13
Buergers Disease Prognosis

• The symptoms of Buerger's disease may disappear
  if tobacco use is stopped. If the affected
  extremity is to be saved, the patient must stop
  smoking. If infection or gangrene occurs,
  amputation of the affect extremity may be
  necessary.

14
Some People Just CANT Quit!(Even if it costs an
arm a leg!)