Buerger's Disease: Symptoms and Therapy

00:01 The symptoms, of course: There's quite a lot of discomfort, particularly in the fingertips. There may also be claudication when walking.

00:09 Patients are very sensitive to cold; that increases the pain in the hands and the fingertips.

00:14 There are diminished or absent peripheral pulses. The extremities may be blue because of lack of blood flow, and there's often thin, very shiny skin with reduced hair growth and then ulcerations and gangrene as we've talked about.

00:33 The therapy: Number one, patients have to stop smoking. There are a number of medications that dilate the blood vessels. This improves blood flow to the little distal areas of the fingers. Sometimes, a sympathectomy—actually interrupting the sympathetic autonomic nerves that go out to the peripheral areas—can actually decrease the amount of spasm in the blood vessels. Spasm can also decrease the blood flow. But the problem with a sympathectomy is you can't reverse it. It's not reversible, whereas with the drugs, you can always reverse it. And unfortunately, in many instances, amputation is necessary for the gangrene that develops in the fingertips.