Buerger's Disease Causes, Symptoms and Treatment
Buerger's Disease Plot Summary:
Buerger's Disease is a disease that is usually seen in young, smoking men and is characterized by occlusion of small arteries in the legs or hands. It usually occurs when the wound caused by nail cutting on the feet does not heal, and the wound grows and becomes infected over time. It may cause toe and foot loss in the later stages. Delay in diagnosis causes this advanced condition. Peripheral angiography or computed tomographic angiography is sufficient to make the diagnosis.
Patients describe pain when walking and lifting their feet. By hanging your foot, the pain decreases, but foot swelling increases. Stress, cold, exertion trigger pain.
Since the blocked artery is small in diameter and extends distally, bypass cannot usually be performed. Artificial or venous bypass surgery performed below the knee is very rarely suitable. In addition, trying to open it angiographically will cause further damage to the vessel lumen (wall), causing clot cells to accumulate to heal the damaged vessel wall and the obstruction to move to higher levels. In other words, after a short time, their complaints become more severe than before and limb loss accelerates.
Beginning of treatment after diagnosis,
Buerger Hastalığı tedavisinin başlangıcı sigaranın tam olarak bırakılmasıdır. Çoğunlukla sigaranın bırakılması hastalığın ilerlemesini durdurur. Tedavide öncelikle zarar vermemek gözetilir bu amaçla da eğer bypass yapılamıyorsa son 60 yıllık tedavi olan ve %87-90 iyileşme sağlayabilen sempatektomi ameliyatıdır.
It is performed to eliminate the effect of sympathetic activity in that area, which is generally effective in cold, stress, etc. situations and causes vasospasm (constriction) of the arteries.
A small incision is made in the front of the abdomen, the back is reached without opening the abdominal membrane, and the sympathetic chain is removed. There are no complications in experienced hands.
Wound healing accelerates within 1 week to 1 month after surgery and increased foot blood circulation eliminates pain. In the long term; Recurrence of the disease is very unlikely as new nutritional collaterals (capillaries) will form and increase the nutrition of the foot.
All About Buerger's Disease
Prof. Dr. Yavuz Beşoğul
Buerger's disease is a disease that affects small and medium-sized arteries and can lead to gangrene in the fingers and toes, and is more common in young men and smokers.
Buerger's Disease Surgery
If Buerger's disease is diagnosed, the only definitive treatment is sympathectomy surgery. The most important of these is to remove a tiny nervous system from the abdomen, called lumbar sympathectomy. This nervous system is the nervous system that only allows the foot veins to contract in cold weather. It is not a walking, running, or any motor neuron system or a sensory nerve system in any way. If the same thing happens to the hands, a sympathectomy called thoracic surgery is performed on the hands. Likewise, the nervous system that contracts the tiny muscles going to the hands is removed, and the patient benefits 70-80 percent without any complications.
It is extremely important to stop smoking as soon as possible in the treatment of Buerger's disease.
Operation Time
2-6 Hours
Recovery Time
4-6 Weeks
Discharge Time
3-5 Days
Buerger's Disease Symptoms
Buerger's disease is a disease generally seen in young male patients. In this disease, the patient may not realize it on his own. Because it gives very insidious symptoms. Sometimes a wound opened while cutting a nail does not close. This applies to toenails. Since it may also occur on the hands, the same thing can be seen on the fingernails. At a young age, there may be symptoms such as hair loss on the feet, coldness in the feet, feeling very cold especially in the winter months, not feeling much when the feet are placed in the heat, sometimes bruising on the fingers, and the wounds growing larger and becoming infected or inflamed.
Diagnosis of Buerger's Disease
Diagnosis of Buerger's disease is made by tomographic angiography and computed tomography.
Causes of Buerger's Disease
It is a disease that occurs especially in young men who smoke. It can occur in the twenties and thirties, under the age of 45. It may occur in a single leg or sometimes in both legs, such as lack of nutrition, malnutrition, and failure to develop nails in the foot veins, especially in the thin fingers.
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Buerger's Disease Treatment Methods
In the treatment of this disease, the first thing to do is to stop smoking 100 percent. Sometimes symptoms may decrease or disappear after quitting smoking. However, in addition to some medications used in the treatment, sympathectomy surgeries should be performed in order to reduce the first degree sympathetic activity, that is, to reduce the nerve activity that constricts the vessels.
The characteristic of the disease is coldness in the fingers or feet, wilting of the fingers, nail loss, or wounds that do not heal. If the patient is not noticed in time as a result of these, it may be detected that the patient is late with the tomography performed. If the toes become gangrene or go further and gangrene the foot, the foot may undergo amputation or amputation. But there is no cure for this. If such a situation has started, sometimes a 90-95 percent recovery rate can be achieved for the patient with minor surgeries. The most important factor is that the patient stops smoking. In addition, if the wound on the foot does not heal, it should never be cut and treated first.
During the healing of the wound, performing sympathectomy surgery, which is an old treatment method for Buerger's disease, and sometimes bypassing if the clogged vein involves the medium-sized artery, can save the patient's leg, arm, no matter which limb he/she uses, and a young person can be saved from becoming disabled. .
With timely detection, good research and finding people who actually apply the surgical methods of this job, a 90-95 percent recovery rate, sometimes a hundred percent recovery rate, can be achieved by performing this surgery.
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Istanbul Avrupa Bahçelievler Merkez, Bahçelievler Mh, Talatpaşa Bulv, Begonyalı Sokak No:7 D:9, 34180 Bahçelievler/İstanbul
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Frequently Asked Questions About Tricuspid Valve Surgery
Buerger's Disease Recovery Time
- The recovery period for Buerger's disease, whose medical name is tao-thromboangiitis obliterans, may vary depending on the progression of the disease. Patients begin to experience significant changes within a few weeks after stopping tobacco use. If the disease becomes chronic, recovery may take years. However, if the patient stops using tobacco and continues treatment, the risk of gangrene is minimized, even in advanced cases.
Complaints of Buerger's Patients
- Bruising on fingers
- Failure to close wounds on fingernails and toenails
- Loss of foot hair
- Feeling very cold in winter
- standing cold
- The foot does not feel much when put in heat
Is Buerger's Disease Genetic?
Buerger's disease is a vascular occlusion disease that develops directly due to cigarette allergy (caused by smoking or exposure to cigarette smoke). Although the biggest cause is tobacco use, the causes of this disease may not always be fully identified. Hereditary characteristics and genetic transmission are among the causes of Buerger's disease.
Which Doctor Treats Buerger's Disease?
Buerger's problem, which is one of the cardiovascular diseases, is treated by cardiovascular surgeons. Buerger patients are followed and treated by cardiovascular surgeons experienced in this field.
Prof. Dr. Academic Statements from Yavuz Beşoğul about Buerger's Disease
It is cell infiltration and thrombus formation in the intima, media and adventitia of small and medium-sized arteries in active or passive smokers, the etiology of which is unknown. As a result, all layers of the artery wall were involved. It is usually seen in men under the age of 40.
There may be symptoms such as mild ischemia and pain in the extremity in the beginning, loss of sensation in the later stages, increased edema, and wound opening in the fingers. If the diagnosis cannot be made clinically, angiography should be performed. In angiography, the presence of widespread collateral arteries along with the lack of blood supply to the distal arteries is noteworthy.
In treatment, it is important to first quit smoking, keep that extremity warm, protect it from infection, and for this purpose, nail care and fungus treatment. In addition, the use of antiplatelets and, if there is infection, local and systemic antibiotics are included in the medical treatment.
Surgical revascularization is achieved by bypass grafting in angiographically suitable patients. Sympathectomy is the most ideal method to increase superficial blood flow in patients who cannot undergo revascularization. In lumbar sympathectomy, retroperitoneal intervention is performed on stages 2-4. sympathetic ganglia and chain are removed.