Distal limb ischemia in young heavy smoker, suspected Buerger disease
Recommended: CTA / MRA Extremity (segmental occlusion + corkscrew collaterals) is the preferred imaging study for distal limb ischemia in young heavy smoker, suspected buerger disease. Thromboangiitis obliterans.
Recommended study
CTA / MRA Extremity (segmental occlusion + corkscrew collaterals)
Thromboangiitis obliterans. Small/medium artery non-atherosclerotic occlusion. Smoking cessation is treatment.
If the default doesn't apply
Definitive angiography
Catheter angiography of upper + lower limbs
IV contrast
Watch-outs
Continued smoking → amputation
Strict smoking cessation is the only effective treatment; nicotine replacement also harmful.
Pearls
- Corkscrew collaterals around occluded segments — classic finding.
- Spares proximal vessels; predominantly affects digits / palmar arch.
- Migratory superficial thrombophlebitis common.