Buerger’s disease, also known as “pruning disease” colloquially, is a type of peripheral artery disease that usually affects men with smoking habits. This disease, which causes clogging of the arteries in the arms and legs, can negatively affect the blood circulation and cause the tissues to remain oxygen-free if it is not treated and smoking is continued. As a result, serious and life-affecting operations such as amputation (amputation) of the limbs may become the only treatment option. Quitting smoking is the only way to stop the progression of the disease. For this reason, smokers should abandon this habit as soon as possible in order to protect themselves from this disease, and existing patients to prevent their illnesses from causing serious health problems.
What is Buerger’s disease?
Buerger’s disease is a rare disease of the arteries and veins of the arms and legs. In Buerger’s disease, also called thromboangiitis obliterans, blood vessels become inflamed, swollen, and vascular occlusion develops due to the formation of blood clots. This situation damages and destroys the skin tissues after a while and leads to serious complications that can progress to infection and gangrene in later times. Buerger’s disease occurs primarily in the hands and feet. It can then spread to arms, legs, or even larger areas. Studies have revealed that all patients with this disease use tobacco products. Therefore, the most important prerequisite for preventing or treating the disease is to quit the use of tobacco products. If sick individuals continue to use tobacco, amputation of a limb or entire may be necessary. In cases where amputation is not performed, the disease may spread to larger areas and lead to much more serious conditions. As a result, larger amputations may be necessary and even life-threatening. The disease affects all age or racial groups. In addition, it is more likely to be seen in Asian or Middle Eastern men between the ages of 40-45 compared to other age groups and geographic regions.
What are the symptoms of Buerger’s disease?
Buerger’s disease has characteristic symptoms common to almost all patients. Usually, the first symptom of the disease is pain radiating from the hands and feet to the arms and legs. At first, the milder pain intensifies as the disease progresses. The pains can cause limping while walking and are more intense when resting. Pain can become unbearable in stressful times for patients or when they feel cold. In addition to all these, some changes occur in the hands and feet. These changes;
- The skin appears pale, red, or blue in color,
- Thinning or shining of the skin,
- Thinning or shedding of hair,
- It is seen as cold, numbness, and tingling in the hands or feet.
In addition to the symptoms on the hands and feet, painful and open wounds may occur on the fingers and toes. When the fingers are cold, they turn pale and swelling occurs in the veins just under the skin. This condition often indicates a clot in the blood vessel. Buerger’s disease, which causes serious problems in blood vessels, also leads to loss of strength and strength. Sick individuals cannot move their joints as they wish over time and limitation of movement occurs. The reason for this restriction is that the blood flow is now reduced in the joints. After this stage, urgent treatment is required and delaying treatment can lead to amputation.
What are the causes of Buerger’s disease?
Although the exact cause of the disease is unknown, it is known that tobacco use triggers Buerger’s disease. However, it is not scientifically known what complications tobacco causes. The most common view is that the chemicals in tobacco irritate the lining of blood vessels, causing them to swell, causing inflammation and clots. Some experts think that the disease may be caused by a genetic predisposition. It is also widely believed that the disease is caused by autoimmune responses when the body’s immune system mistakenly attacks healthy tissues. In addition to smoking, passive smoking, including cigars, chewing tobacco, and hookah, can also trigger the disease. The risk rate is higher in those who smoke more than half a pack a day. Buerger’s disease is prevalent in the Mediterranean, Middle East, and Asian regions where smoking is common. In addition, chronic gum diseases and inflammation are associated with this disease. However, the exact cause is not yet clear. In addition, Buerger’s disease is more common in men than in women. This can be attributed to the fact that men smoke more than women.
How is Buerger’s disease diagnosed?
No specific test has yet been found to directly diagnose Buerger’s disease. Generally, doctors use some tests to rule out other possibilities and to diagnose this disease. Among the most common of these tests are blood tests. By looking at the number of certain substances in the blood, other diseases with symptoms similar to Buerger’s disease can be ruled out. Autoimmune diseases such as scleroderma and lupus, blood clotting problems, and diseases such as diabetes can be excluded with blood tests. Apart from blood tests, a series of simple tests called the “Allen Test” are used to control blood flow. While applying this, the doctor asks the patient to clench his fist and puts pressure on the veins that provide blood flow to the hand. The patient’s fist then opens and the doctor relieves the pressure on the artery and other veins. How soon the hand color returns to normal can give an idea about Buerger’s disease. The angiogram helps the doctor to see the condition of the arteries. Using the angiogram in conjunction with MRI or CT provides a three-dimensional view of the vessels. In addition, the view of the veins can be obtained by placing a catheter into the artery. Any arterial occlusion or abnormality can be easily detected by examining the image of the veins. Buerger’s disease does not always spread to all limbs at the same time. However, these tests are useful in diagnosing the disease at an early stage. The success rate of the treatment of the disease, which can be diagnosed in the early stages, is higher.
What are the treatment methods for Buerger’s disease?
Quitting cigarettes and tobacco products prevents the progression of Buerger’s disease. It is not a direct treatment method, but slowing the progression of the disease makes the treatments be applied more successful. Even a few cigarettes per day will cause the disease to progress. Apart from this, there are several other approaches for the treatment of the disease. It is recommended to use drugs that will dilate blood vessels, improve blood flow and eliminate blood clots. Arms and legs can be squeezed intermittently to increase blood flow in the arms and legs. If the infection has spread too much and blood flow to the joints has stopped, nerve surgery can be performed according to amputation or conditions. Without amputation, the pain can be unbearable and the gangrene can spread to other areas. This leads to the loss of larger limbs in later stages. Newly used drugs that allow the growth of blood vessels have also been used in the treatment of the disease. Studies have shown that these drugs are beneficial in some individuals with Buerger’s disease. In addition, restoring blood flow can be attempted with a thin catheter inserted into blood vessels. However, a procedure called endovascular therapy can be applied. However, both treatments are not preferred since they did not give very positive results in the past.
The best treatment for Buerger’s disease is to stop using tobacco products as a preventive measure. If you have symptoms of Buerger’s disease, it is useful to consult a doctor immediately.
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