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עמוד בית
Wed, 04.02.26

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January 2026
Eden Gerszman MD, Isaac Sitton MD, Veronica Sandler MD, Ahmad Mahamid MD, Alexandra Cretu MD, Arie Bitterman MD

Thromboangiitis obliterans, also known as Buerger’s disease, is a nonatherosclerotic inflammatory disorder that predominantly involves the small- and medium-sized arteries, veins, and nerves. This condition primarily affects the extremities. Manifestations in other anatomical locations are exceptionally rare. It is almost exclusively seen in relatively young smokers, with an incidence rate of 12.6 per 100,000 individuals in the United States [1].

Tobacco smoking is the most significant risk factor for thromboangiitis obliterans. It plays a crucial role in both the initiation and progression of the disease. Patients typically present with ischemic symptoms resulting from occlusion of the small vessels in the extremities, whereas other symptoms are infrequent [1,2].

The diagnosis is mainly clinical, requiring a history of smoking, characteristic physical findings, and vascular abnormalities observed on imaging. Biopsy is seldom necessary for diagnosis, and smoking cessation remains the sole effective intervention to prevent disease progression [1,2].

In this report, we present the clinical course and surgical management of a 57-year-old male patient with a colonic mass that was histopathologically diagnosed as thromboangiitis obliterans.

July 2014
A. Nobre MD, Walber P. Vieira MD, Francisco E.S. da Rocha MD, Jozelio F. de Carvalho MD PhD and Carlos E.M. Rodrigues MD PhD

Smoking is a risk factor for thromboangiitis obliterans (TAO, Buerger’s disease) and arteriosclerosis, but there are few cases of coronary heart disease (CAD)-associated Buerger's disease. A literature search for articles in English, Spanish and French published between 1966 and 2012 on patients with coronary involvement and TAO revealed 12 patients. We describe an additional case with involvement of the central nervous system, myocardium and large-diameter proximal arteries. The main clinical manifestations in these 13 cases were lower limb claudication and acute thoracic pain. The histologic findings showed thrombosis with unbroken internal elastic lamina and intimal clusters of granulocytes; coronary angiography revealed predominant involvement of the left anterior descending and right coronary artery. Treatment included coronary bypass procedures, coronary angioplasty, smoking cessation, and anticoagulant therapy. A complete therapeutic response was observed in half the patients. This review of all published cases of TAO patients with coronary symptoms, together with our patient, demonstrates the rarity of this clinical association. Patients under age 40 with CAD but no prominent cardiovascular risk factors besides smoking should be evaluated for the presence of Buerger's disease.

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