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BUERGER’S DISEASE (Thromboangitis Obliterans) DESCRIPTION Buerger’s disease is characterized by recurring in ammation of the intermediate and small fl 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. Buerger’s disease is believed to be an autoimmune disease that results in occlusion of distal vessels. The cause of Buerger’s 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. Buerger’s 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
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BUERGER’S DISEASE (Thromboangitis Obliterans)
DESCRIPTION
Buerger’s disease is characterized by recurring inflammation 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. Buerger’s disease is believed to be an autoimmune disease that results in occlusion of distal vessels. The cause of Buerger’s 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. Buerger’s disease is generally bilateral and symmetric with focal lesions
ASSESSMENT
rampsalf and foot claudification especially after exerciseyanosisold sensitivityhillingonstant digital rest painlubbing of fingers
ain (Burning) aggravated by nicotine, rolonged wound healingresence of ulcersresence of gangrene resence of tingling sensation aresthesiasedal pulses diminishedulses(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 infectionrovide treatment of ulceration and gangrene rovide conservative débridement of necrotic tissueromote cessation of tobacco
MEDICAL MANAGEMENT
Regional Sympathetic Block/Ganglionectomy- may be useful in some instances to produce vasodilation and increase blood flow.
SURGICAL MANAGEMENT
Toe Amputation/Transmetatarsal AmputationIf gangrene of a toe develops as a result of arterial occlusive disease in the leg
