Iranian Journal of

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Buerger’s disease or thromboangiitis obliterans is a non-atherosclerotic vascular disease that causes inflammation of the blood vessels and arterial occlusion in the extremities, resulting in impaired distal perfusion. Tobacco use is the main etiologic factor and is responsible for the progression and recurrence of the symptoms. Also, several contributing factors to the pathogenesis of the disease have been suggested, such as immunologic mechanisms and genetic predisposition. The disease is more prevalent in the Middle East and the Far East than in North America and Western Europe. Patients are often young male smokers, who may present with burning pain and paresthesia, cold sensitivity, purple discoloration, superficial thrombophlebitis, intermittent claudication, ischemic rest pain, ulcer, or gangrene.  The diagnosis is based on the clinical criteria, such as Shionoya, Olin, Papa, and Mills criteria.  Smoking cessation is the only effective treatment for pain relief, blood flow improvement, and limb salvage.  However, additional therapeutic options have been proposed, such as sympathectomy, prostaglandin infusion, endovascular angioplasty, and surgical revascularization. If treatment measures fail, amputation may be inevitable.

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