Buerger's

Disease
Thromboangiitis
Obliterans
• an inflammatory disease of the small and
medium sized arteries and veins of the
extremities
• often seen in men and appears to be 
directly related to smoking
• an acute inflammation and thrombosis
(clotting) of arteries and veins of the hands
and feet.
• is strongly associated with use of tobacco
products, primarily from smoking, but also
from smokeless tobacco
 History
• Buerger's disease was first reported by
Felix von Winiwarter in 1879 in Germany
• 1908, however, that the disease was
given its first accurate pathological
description, by Leo Buerger at Mount
Sinai Hospital in New York City
• Buerger called it presenile spontaneous
gangrene after studying amputations in
11 patients.
Who gets Buerger's Disease
• young male (e.g., 20–40 years old) who
is a heavy cigarette smoker
• recently a higher percentage of women
and people over the age of 50 have
been recognized to have this disease
• most common in the Orient, Southeast
Asia, India and the Middle East
 Causes Buerger's Disease
• unknown.
• cigarette smoking
• autoimmune reaction triggered by some
constituent of tobacco.
• history of inflammation of a vein (phlebitis),
• Socioeconomic (out door and manual
workers)
Active smokers Immuno pathogenesis
CONTININE, the
major metabolite Hypercoagulable
of nicotine state

thickening of blood clots

the blood
vessel walls

occluding the arteries

progressive decrease in the blood flow to
the affected areas

decrease in the blood supply (arterial ischemia)

Inflammation occurs in small and medium-sized

arteries and veins near the surface of the limb

restricted blood supply

lack of blood flow

decay of tissue gangrene
Classic symptoms and
signs
Claudication in the
feet and/or hands
Pain at rest
begins in the extremities
radiate to other (more
central) parts of the
body
Classic symptoms and signs

Skin ulcerations and

gangrene of the digits
(fingers and toes)

PARASTHESIA: cold
sensitivity in the
hands

Thrombophlebitis
Classic symptoms and signs

Raynaud’s phenomenon
hands turn color--
white, blue, and then
red--when exposed to
the cold.
Numbness and/or
tingling in the limbs
 Diagnosis

angiogram demonstrating lack of blood

flow to vessels of the hand
Treatment
The only way to
prevent the
progression of the
disease is to

abstain from
all tobacco
products.
 Smoker's Body
Seven out of every 10
smokers start during
teenage years
Over 4000 harmful
chemicals found in
tobacco
Every 8 seconds someone
dies as a result of using
tobacco
die 20 to 25 years earlier
 Nursing Diagnosis
• Altered peripheral tissue perfusion related to
compromised circulation
• Chronic pain related to impaired ability of
the peripheral vessels to supply tissues with
oxygen
• Risk for impaired skin integrity related to
compromised circulation
• Deficient knowledge regarding self care
activities
 Nursing Management
• Assist to develop and implement a plan to
stop smoking
• Assist in management of pain
• Assist in management of self care
• Prepare pre operatively and post
operative care after amputation
• Teach the client proper care of foot and
hands
THANK YOU
FOR BEING
ATTENTIVE