Thromboangiitis Obliterans (Buerger’s Disease)

Thromboangiitis obliterans (TAO), or Buerger’s disease, is a segmental inflammatory disease that most commonly affects small- and medium-sized arteries, veins, and nerves, especially in upper and lower extremities. Von Winiwater first reported a case of TAO in 1879, but it was Leo Buerger’s who quite accurately described the pathologic features in 11 amputated limbs in 1908. The pathologic hallmark of TAO is a highly inflammatory thrombus with relative sparing of the blood vessel wall. It is this feature, as well as the absence of serologic markers of acute inflammation and immunologic activation, that differentiates TAO from the necrotizing vasculitides. In early reports, TAO was almost exclusively found in young men; however, in the more recent Western literature TAO has become more prevalent in women. Most patients are heavy cigarette smokers, but other forms of tobacco use have also been reported in patients with TAO.