BUERGERS DISEASE

(Thromboangitis Obliterans)
DESCRIPTION
Buergers disease is characterized by recurring
inammation of the intermediate and small arteries and
veins of the lower and (in rare cases) upper extremities. It
results in thrombus formation and occlusion of the vessels.
It is differentiated from other vessel diseases by its
microscopic appearance. Buergers disease is believed to be an
autoimmune disease that results in occlusion of distal vessels.
The cause of Buergers disease is unknown, but it is believed to
be an autoimmune vasculitis. It occurs most often in men
between the ages of 20 and 35 years, and it has been reported in
all races and in many areas of the world. There is considerable evidence that heavy
smoking or chewing of tobacco is a causative or an
aggravating factor (Frost-Rude et al., 2000). Generally, the
lower extremities are affected, but arteries in the upper
extremities or viscera can also be involved. Buergers disease
is generally bilateral and symmetric with focal lesions

ASSESSMENT
ramps
alf and foot claudification especially after exercise
yanosis
old sensitivity
hilling
onstant digital rest pain
lubbing of fingers

ain (Burning) aggravated by nicotine,

rolonged wound healing
resence of ulcers
resence of gangrene
resence of tingling sensation
aresthesias
edal pulses diminished
ulses(radial, ulnar artery) absent/diminished

DIAGNOSTIC FINDINGS
Contrast Angiography- is performed to demonstrate the diseased portion of
the anatomy
Duplex Ultrasonography- is used to document patency of the proximal vessels
and to visualize the extent of distal disease.
Segmental Limb Blood - are taken to demonstrate the distal location of the
lesions or occlusions

NURSING MANAGEMENT

romote circulation to the extremities

revent the progression of the disease
rotect the extremities from trauma and infection
rovide treatment of ulceration and gangrene
rovide conservative dbridement of necrotic tissue
romote cessation of tobacco

MEDICAL MANAGEMENT
Regional Sympathetic Block/Ganglionectomy- may be useful in some instances to
produce vasodilation and increase blood ow.
SURGICAL MANAGEMENT
Toe Amputation/Transmetatarsal Amputation
If gangrene of a toe develops as a result of arterial occlusive disease in the
leg