What is the definition of Thromboangiitis Obliterans?

Thromboangiitis obliterans is a rare disease in which blood vessels of the hands and feet become blocked.

What are the alternative names for Thromboangiitis Obliterans?

Buerger disease

What are the causes for Thromboangiitis Obliterans?

Thromboangiitis obliterans (Buerger disease) is caused by small blood vessels that become inflamed and swollen. The blood vessels then narrow or get blocked by blood clots (thrombosis). Blood vessels of the hands and feet are mostly affected. Arteries are more affected than veins. Average age when symptoms begin is around 35. Women and older adults are affected less often.

This condition mostly affects young men ages 20 to 45 who are heavy smokers or chew tobacco. Female smokers may also be affected. The condition affects more people in the Middle East, Asia, the Mediterranean, and Eastern Europe. Many people with this problem have poor dental health, most likely due to tobacco use.

What are the symptoms for Thromboangiitis Obliterans?

Symptoms most often affect 2 or more limbs and may include:

  • Fingers or toes that appear pale, red, or bluish and feel cold to the touch.
  • Sudden severe pain in the hands and feet. The pain may feel like a burning or tingling.
  • Pain in the hands and feet that most often occurs when at rest. The pain may be worse when the hands and feet get cold or during emotional stress.
  • Pain in the legs, ankles, or feet when walking (intermittent claudication). The pain is often located in the arch of the foot.
  • Skin changes or small painful ulcers on the fingers or toes.
  • Occasionally, arthritis in the wrists or knees develops before the blood vessels become blocked.

What are the current treatments for Thromboangiitis Obliterans?

There is no cure for thromboangiitis obliterans. The goal of treatment is to control symptoms and prevent the disease from getting worse.

Stopping tobacco use of any kind is key to controlling the disease. Smoking cessation treatments are strongly recommended. It is also important to avoid cold temperatures and other conditions that reduce blood flow in the hands and feet.

Applying warmth and doing gentle exercises can help increase circulation.

Aspirin and medicines that open the blood vessels (vasodilators) may help. In very bad cases, surgery to cut the nerves to the area (surgical sympathectomy) can help control pain. Rarely, bypass surgery is considered in certain people.

It may become necessary to amputate the fingers or toes if the area becomes very infected and tissue dies.

What is the outlook (prognosis) for Thromboangiitis Obliterans?

Symptoms of thromboangiitis obliterans may go away if the person stops tobacco use. People who continue to use tobacco may need repeated amputations.

What are the possible complications for Thromboangiitis Obliterans?

Complications include:

  • Tissue death (gangrene)
  • Amputation of fingers or toes
  • Loss of blood flow in the limb of the affected fingers or toes

When should I contact a medical professional for Thromboangiitis Obliterans?

Call your health care provider if:

  • You have symptoms of thromboangiitis obliterans.
    You have symptoms of thromboangiitis obliterans.
  • You have thromboangiitis obliterans and symptoms get worse, even with treatment.
    You have thromboangiitis obliterans and symptoms get worse, even with treatment.
  • You develop new symptoms.
    You develop new symptoms.

How do I prevent Thromboangiitis Obliterans?

People with a history of Raynaud phenomenon or blue, painful fingers or toes, especially with ulcers, should not use any form of tobacco.



Akar AR, Inan B. Thromboangiitis obliterans (Buerger disease). In: Sidawy AN, Perler BA, eds. Rutherford's Vascular Surgery and Endovascular Therapy. 9th ed. Philadelphia, PA: Elsevier; 2019:chap 138.

Gupta N, Wahlgren CM, Azizzadeh A, Gewertz BL. Buerger's disease (Thromboangiitis obliterans). In: Cameron JL, Cameron AM, eds. Current Surgical Therapy. 13th ed. Philadelphia, PA: Elsevier; 2020:1054-1057.

Jaff MR, Bartheolomew JR. Other peripheral arterial diseases. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 72.

  • Condition: Critical Ischemia of Lower Extremities
  • Journal: Khirurgiia
  • Treatment Used: Indirect Revascularization Surgery
  • Number of Patients: 210
  • Published —
In this study, researchers evaluated the effectiveness of indirect revascularization surgery for the treatment of critical ischemia of lower extremities.
  • Condition: Diabetic Foot
  • Journal: Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery
  • Treatment Used: Tibial Transverse Transport (TTT)
  • Number of Patients: 516
  • Published —
This study reported results on tibial transverse transport (TTT) for the treatment of diabetic foot.