Buerger disease (Thromboangiitis obliterans) in upper extremity disease

Buerger disease, also known as thromboangiitis obliterans,obliterans (TAO), is an inflammatory vaso-occlusive disorder that predominantly affects young tobacco users. The disease is characterized by distal, segmental arterial occlusions and frequently associated superficial thrombophlebitis. Upper extremity involvement occurs in a substantial proportion of affected patients, manifesting as digital ischemia and tissue loss. Diagnosis relies on clinical criteria (young smoker, distal ischemia, exclusion of autoimmune diseases) and angiographic findings of corkscrew collaterals. Management mandates absolute smoking cessation, as no other therapy prevents progression. RevascularizationWhile revascularization is rarelyoften feasiblechallenging due to the distal nature of the disease, thoughendovascular sympathectomyangioplasty has emerged as a feasible option for patients with chronic limb-threatening ischemia (CLTI), showing reasonable early and late outcomes in systematic reviews [@galyfos2022]. Sympathectomy or iloprost may also provide symptomatic relief in select cases [@olin2000].