Acta Medica Iranica 2009. 47(3):215-219.

Buerger’s Disease in Tehran University of Medical Sciences Hospitals: A Fifteen Years Study
Javad Salimi, Mohammad Reza Zafarghandi, Patricia Khashayar, Mehran Ebrahimi


Buerger's disease is an occlusive inflammatory disease of the small and medium-sized arteries and accounts for a variable proportion of patients with peripheral vascular disease throughout the world. The aim of this study was to review the records of Buerger's disease patients admitted to surgery wards of our university hospitals. 277 patients with Buerger's disease were surgically treated between 1987 and 2002, in affiliated hospitals of Tehran University of Medical Sciences, in Iran. Two hundred and seventy three (98.6%) of the patients were male, aged 41.5 ± 11 years (mean ± SD); 99.6% of which were smokers with an average of 22.9 pack/years tobacco use. The major complaints included: ischemic ulcers in 203 (73.3%, CI 95%: 0.68-0.77) patients, rest pain in 201 (72.6%, CI 95%: 0.64-0.73), paresthesia in 143 (51.3%, CI 95%: 0.48- 0.58). Vascular bypass, sympathectomy and amputation were performed in 9.7% (CI 95%: 0.08-0.14) and 69.3% (CI 95%: 0.51-0.60) and 59.6% (CI 95%: 0.65-0.73) of the patients, respectively. Lumbar sympathectomy was carried out in 177 (63.9%) patients, while 15 (5.4%) patients underwent thoracic sympathectomy. In our study, afflicted patients were mostly young males, inveterate tobacco smokers. Patients presented frequently with ischemic ulcers or severe rest pain; thrombophlebitis and Raynaud's phenomenon were infrequent. Vascular reconstruction was rarely possible due to distal and segmental involvement; therefore sympathectomy and amputation were inevitable in a large group of patients in this study.


Buerger’s disease; thromboangiitis obliterans; smoking; vasculitis

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Olin JW. Thromboangiitis obliterans (Buerger's disease). N Engl J Med 2000; 343(12): 864-9.

Mills JL, Porter JM. Buerger's disease (thromboangiitis obliterans). Ann Vasc Surg 1991; 5(6): 570-2.

Leger P, Pathak A, Hajji L, Faivre-Carrere C, Boccalon H.Buerger’s disease or thromboangiitis obliterans. Ann Cardiol Angeiol 2001; 50(2): 82-9.

Kobayashi M, Nishikimi N, Komori K. Current Pathological and Clinical Aspects of Buerger’s Disease in Japan. Ann Vasc Surg 2006; 20(1): 148-56.

Bozkurt AK, Besirli K, Koksal C, Sirin G, Yüceyar L, Tüzün H, Sayin AG. Surgical treatment of Buerger’s disease. Vascular 2004; 12(3): 192-7.

Salimi J, Tavakkoli H, Salimzadeh A, Ghadimi H, Habibi G, Masoumi AA. Clinical Characteristics of Buerger's diseasein Iran. J Coll Physicians Surg Pak 2008; 18(8): 502-5.

Shionoya S. Diagnostic criteria of Buerger’s disease. Int J Cardiol 1998; 66 Suppl 1: S243-5.

Rahman M, Chowdhury AS, Fukui T, Hira K, Shimbo T.Association of thromboangiitis obliterans with cigarette and bidi smoking in Bangladesh: a case-control study. Int J Epidemiol 2000; 29(2): 266-70.

Olin JW, Young JR, Graor RA, Ruschhaupt WF, Bartholomew JR. The changing clinical spectrum of thromboangiitis obliterans (Buerger’s disease). Circulation 1990; 82(5 Suppl): IV3-8.

Mills JL, Taylor LJ, Porter JM. Buerger’s disease in the modern era. Am J Surg 1987; 154: 123-9.

Sasaki S, Sakuma M, Yasuda K. Current status of thromboangiitisobliterans (Buerger's disease) in Japan. Int J Cardiol 2000; 75 Suppl 1: S175-81.

Tavakoli H, Rezaii J, Esfandiari K, Salimi J, Rashidi A.Buerger's disease: a 10-year experience in Tehran, Iran.Clin Rheumatol 2008; 27(3): 369-71.

Papa M, Bass A, Adar R, Halperin Z, Schneiderman J, Becker CG, et al. Autoimmune mechanisms in thromboangiitis obliterans (Buerger's disease): the role of tobacco antigenand the major histocompatibility complex. Surgery 1992; 111(5): 527-31.

Eichhorn J, Sima D, Lindschau C, Turowski A, Schmidt H, Schneider W, et al. Antiendothelial cell antibodies in thromboangiitis obliterans. Am J Med Sci 1998; 315(1): 17-23.

Suzuki S, Yamada I, Himeno Y. Angiographic findings in Buerger disease. Int J Cardiol 1996; 54 Suppl: S189-95.

Jiménez-Paredes CA, Cañas-Dávila CA, Sanchez A, Restrepo JF, Peña M, Iglesias-Gamarra A. Buerger's disease at the 'San Juan De Dios' Hospital, Santa Fe De Bogota, Colombia. Int J Cardiol 1998; 66 Suppl 1: S267-72.

Corelli F. Buerger's disease: cigarette smoker disease mayalways be cured by medical therapy alone. Uselessness of operative treatment. J Cardiovasc Surg (Torino) 1973; 14(1): 28-36.

Dilege S, Aksoy M, Kayabali M, Genc FA, Senturk M, Baktiroglu S. Vascular reconstruction in Buerger's disease:is it feasible? Surg Today 2002; 32(12): 1042-7.

Sayin A, Bozkurt AK, Tüzün H, Vural FS, Erdog G, Ozer M. Surgical treatment of Buerger's disease: experience with 216 patients. Cardiovasc Surg 1993; 1(4): 377-80.


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