The Clinical Course of Buerger's Disease.

The clinical and social characteristics of 118 patients with Buerger's disease (thromboangiitis obliterans: TAO) were surveyed. The prognosis for many patients is relatively favorable. Arterial reconstruction plays a role in shortening the healing times of ischemic ulcers despite its poor long-term results. Of 118 patients, 13 underwent major lower limb amputation (11%), 33 underwent foot or toe amputation (28%), one underwent hand amputation (1%), and 12 underwent finger amputations (10%) after the onset of the disease. The progression of symptoms was surely influenced by smoking, but this was not the only deleterious factor as there were patients with stable TAO which was unaffected by their continued smoking. In 66 patients, the new occurrence of ulceration and gangrene was not observed over the age of 60. Ten of 13 patients (77%) who underwent major lower limb amputation lost their jobs, but only 7 of 105 patients without major amputation lost their jobs (7%). In all patients, the progression of symptoms was self-limited and recurrent ulcers occurred less frequently with ageing. To avoid factors that markedly influence the quality of life, early treatment and strict instructions prohibiting smoking should be conducted.