Thromboangiitis Obliterans (Buerger’s Disease)

The rare, non-atherosclerotic, segmental inflammatory disease, Thromboangiitis obliterans (TAO), commonly referred to as Buerger's disease, mostly affects the medium and small arteries and veins in the extremities. Although recent epidemiological trends indicate an increase in instances among women due to rising smoking prevalence, it is strongly linked to tobacco use, especially among young male smokers. Distal extremity ischemia, rest pain, skin discoloration, ulceration, and gangrene are clinical manifestations of the condition, which frequently results in limb amputation if left untreated. The "corkscrew" collateral arteries shown on imaging are a crucial diagnostic feature, with illness preserving bigger vessels and visceral organs. Although the exact cause is unknown, environmental, genetic, and immunologic factors—particularly tobacco-induced endothelium dysfunction—play significant roles. In order to rule out mimicking illnesses, the diagnosis is made using clinical criteria, such as Shionoya's criteria, in conjunction with imaging and laboratory testing. The only treatment that has been shown to stop the progression of the disease is quitting smoking. Analgesics, prostaglandin analogs, vasodilators, and antiplatelet medicines are examples of adjunctive medical therapy. In more advanced cases, surgical procedures such as sympathectomy, spinal cord stimulation, the Ilizavor’s technique, and cell treatments employing bone marrow-derived mononuclear cells show promise. Mortality is still low despite the disease's severity, but ischemia agony and limb loss cause a high rate of morbidity. Improving patient outcomes still mostly depends on early diagnosis and rigorous smoke abstinence.