Skip to Main Content


  • • Also known as thromboangiitis obliterans

    • -Characterized as multiple segmental small arteries occlusions in distal extremities

    • Involves all 3 layers of arterial wall with infiltration of round cells

    • Healing of lesion results in fibrous obliteration of lumen in segmental fashion

    • Upper and lower extremities affected

    • Many patients have specific cellular immunity against arterial antigens and elevated immune complexes




  • • Young cigarette-smoking men


Symptoms and Signs


  • • Migratory phlebitis

    • Symptoms range from digital pain to coolness and cyanosis, to necrosis and gangrene

    • Foot claudication may be first symptom

    • On exam, patients often have irregular pattern of ischemia

    • Allen test demonstrates delayed filling of affected digital arteries


Imaging Findings


  • • Angiography findings distinctive but not pathognomonic; tapering of proximal vessel, artery is smooth, not irregular, multiple wispy collateral present


  • • Precise diagnosis only made by microscopic evaluation


  • • HLA typing may distinguish patients with Buerger disease from those with atherosclerosis

    • Microscopic diagnosis necessary

    • -Shows lymphocytic infiltration into all layers of vessel wall

    • Arteriographic findings distinctive but not pathognomonic


  • • Cessation of smoking essential to avoid disease progression and may even become dormant

    • Sympathectomy decreases arterial spasm in some patients

    • Amputation for pain/gangrene






  • • Severe symptoms

    • Necrosis/gangrene



Paraskevas KI. et al. Thromboangiitis obliterans (Buerger's disease): searching for a therapeutic strategy. Angiology 2007 58(1):75-84.  [PubMed: 17351161]

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.


About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessSurgery Full Site: One-Year Subscription

Connect to the full suite of AccessSurgery content and resources including more than 160 instructional videos, 16,000+ high-quality images, interactive board review, 20+ textbooks, and more.

$995 USD
Buy Now

Pay Per View: Timed Access to all of AccessSurgery

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.