Thromboangiitis obliterans (buerger's disease)

A form of vasculitis associated with a highly inflam-matory clot within the lumen as well as inflammation within the vascular wall. Associated with active cigarette smoking, typically moderate to heavy. Tends to involve medium-sized arteries and veins, with the most striking clinical pathology related to arterial disease. Digital ischemia in all four extremities is a hallmark of the disorder, with the involvement of some extremities more characteristic than others. Severe digital ischemia without the evidence of internal organ involvement. Angiography reveals segmental involvement of medium-sized arteries, with abrupt vascular cut-offs and corkscrew collaterals. The major vessel involvement occurs at the levels of the ankle and wrist, with major consequences to the distal extremities. Smoking cessation is the only therapy known to be effective for Buerger's disease.