One of the most frequent vascular diseases in northeastern of Turkey: Thromboangiitis obliterans or Buerger's disease (experience with 344 cases).

Purpose: This is a retrospective clinical study on adult patients treated surgically for Buerger's disease in our region.

Methods: In our clinic, 344 patients with Buerger's disease were surgically treated between 1980 and 2004. The major complaints included foot coldness in 312 (90.6%) patients, color changes in 290 (84.3%), rest pain in 160 (46.5%), claudication in 166 (48.2%) and necrotic ulcers in 185 (53.1%). Lumbar sympathectomy was made in 278 (80.2%) patients, thoracic sympathectomy in 7 (2.2%), thoracic and lumbar sympathectomy in 12 (3.6%), lumbar sympathectomy and femoropopliteal or femorotibial bypass in 30 (9%), and femoropopliteal or femorotibial bypass in 17 (5%).

Results: Color changes were improved in 230 (79.3%) patients, food coldness were decreased in 288 (92.3%) and rest pains were improved in 43 (26.8%). Intermittent claudications decreased in 132 of 166 patients. Necrotic ulcers healed in 30 of 185 patients. Amputation was made totally in 155 (53%) patients in 10 years.

Conclusions: As a nonatherosclerotic, segmental, inflammatory disease, Buerger's disease is casually related to tobacco use. The main goal is to discontinue the use of tobacco. Sympathectomy may be helpful in healing the ulcers and decreasing the symptoms. Vascular reconstruction is rarely possible for patients with Buerger's disease due to segmental involvement and distal nature of the disease.