Regarding Buerger's disease (thromboangiitis obliterans), which of the following statements is MOST accurate?
- A It is a non-inflammatory thrombotic occlusive disease affecting medium and small arteries and veins, strongly associated with tobacco use in young adults ✓
- B It primarily affects large vessels (aorta, iliac) in elderly patients
- C It is treated with systemic corticosteroids as the primary therapy
- D Bypass surgery is the definitive treatment of choice
Correct answer: A. It is a non-inflammatory thrombotic occlusive disease affecting medium and small arteries and veins, strongly associated with tobacco use in young adults
Explanation
Buerger's disease (thromboangiitis obliterans) is a segmental inflammatory thrombotic occlusive disease affecting small and medium-sized arteries and veins, almost exclusively in young male smokers (<45 years). It involves the distal extremities (below knee/elbow) and presents with rest pain, ulceration, and gangrene. The ONLY effective treatment is complete smoking cessation, which halts progression in most cases. Bypass surgery has poor results due to the distal involvement of small vessels.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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