Buerger’s disease, also called thromboangiitis obliterans, is an inflammation of small- and medium-sized blood vessels. Although any artery can be affected, it usually presents with blockages of the arteries to the feet and hands, leading to pain and tissue damage. The disease is found worldwide and can affect people of any race and age group. However, it mainly affects Asian and Middle Eastern men between the ages of 40 and 45 who heavily use, or have heavily used, tobacco products, including chewing tobacco. There isn’t a cure for Buerger’s disease. However, the single-most important factor in improving symptoms and preventing its progression is quitting smoking. In rare cases, the pain may be so severe that a surgical procedure called a sympathectomy may be performed to eliminate the pain.

2. BUERGER'S DISEASE
Presented by
kalyan kumar Msc (N)

3. Definition
• Buerger's disease is a type of vasculitis in which there
is inflammation of the arteries and veins of the hands or
feet. Buerger's disease also called thromboangiitis
obliterans.

4. THE CAUSE OF BUERGER'S DISEASE
• Smoking and the use of chewing tobacco.
• It is theorized that tobacco triggers an autoimmune
reaction, in which the body's immune system mistakes
healthy tissues as potentially dangerous invades into
the body and attacks them.
• This causes inflammation and the development of clots
in the arteries and veins of the hands and feet that are
characteristic of Buerger's disease.
• Buerger's disease occurs most often in young adult men
who are heavy cigarette smokers.

5. PATHOPHYSIOLOGY
• Healthy arteries and veins are critical to supplying vital
oxygen and nutrients to cells and tissues and removing
waste products.
• This circulation is key to the health of the cells and
tissues of the hands and feet.
• Buerger's disease interferes with circulation leading to
ischemia of cells and tissues.
• In ischemia, cells are unable to reproduce normally
recover effectively from injury,and fight infection.

6. SYMPTOMS OF BUERGER'S DISEASE
• Pain in the hands and feet and the development of
sores or lesions that do not heal.
• If Buerger's disease is left untreated, gangrene
(tissue death) can occur.
• Intermittent leg pains
• Leg numbness
• Leg tingling
• Leg burning
• Leg paresthesias

7. DIAGNOSIS
• Medical history
• Tobacco use history
• Physical examination
• Diagnosis of Buerger's disease is based on medical history
and examination combined with ruling out a variety of
other diseases and conditions, such as Raynaud's
phenomenon and other types of vasculitis.
• CBC
• A test called an angiogram may be performed to assist in
diagnosis of Buerger's disease.
• An angiogram is an imaging test that creates a picture of the
arteries and can reveal the artery damage and blockages in
the hands and feet that are typical of Buerger's disease.

8. TREATMENT
• Buerger's disease can often be successfully treated
before the development of complications.
• Treatment involves quitting smoking.
• Low cholesterol diet
• Low salt diet
• Physical exercise
• Control weight
• Surgical- Sympathectomy [Transection of
nerve,ganglion]

9. Complications
• Review possible medical complications related to
Buerger's disease:
• Leg blood clots
• locked leg arteries
• Finger ulcers
• Toe ulcers
• Toe gangrene
• Foot gangrene

10. NURSING MANAGEMENT
• Assessing & monitoring anti coagulant therapy
• Providing comfort
• Applying elastic compression stocking
• Positioning the body & encouraging exercise
• Identify risk factors predisposing patient to DVT,
reevaluate status frequently
• Implement ordered prophylactic regimen Non-
pharmacological & pharmacological
• Assess all of the patients extremities on a regular basis
• Encourage early ambulation & active leg exercise every
hour the patient is awake .
• Monitor for low grade fever to detect thrombophlebitis
• Encourage fluid intake.
• Use of knee gatch (or) pillows under the knees.

11. NURSING DIAGNOSIS
• Acute pain related to venous congestion,impaired
venous return and inflammation.
• Ineffective health maintenance related to lack of
knowledge about disorder and its treatment.
• Risk for impaired skin integrity related to peripheral
tissue perfusion.
• Risk for potential bleeding related to anticoagulant
therapy.