• The Korean Journal of Pain
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• v.14 no.2
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• pp.271-275
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• 2001

Buerger's disease is a nonatherosclerotic occlusive inflammatory disease of the small and medium arteries, and veins of the distal leg or arm. Percutaneous lumbar sympathectomy is used to lower extremity occlusive vascular disease as well as Buerger's disease. Lumbar sympathectomy improves blood flow and provides pain relief in the lower extremity. We report two cases of lumbar sympathectomy using radiofrequency thermocoagulation in patients with Buerger's disease. After no paresthesia and muscle contracture at 50 Hz, 1 volt and 2 Hz, 3 volts, respectively, radiofrequency lesioning was performed for 90 sec at $80^{\circ}C$. After the procedure, both patients showed skin temperature increases greater than $2^{\circ}C$ on the affected extremity. Both patients received relief from pain and symptoms without complications. We consider that lumbar sympathectomy using radiofrequency thermocoagulation is a safe and effective procedure that can relieve pain in patients with Buerger's disease.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.114-119
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• 1996

Buerger's disease is a nonatherosclerogic occlusive inflammatory disease of medium and small arteries, and veins, of unknown cause. It occurs predominantly in young males who are habitual tabacco users. These patients often complain of painful ulcerations of their digits. The care of this disease is very difficult when the treatment is delayed. Consequently, early treatments are most important to patients with Buerger's disease. This disease can be treated with sympathetic block such as stellate ganglion block for upper extremities and lumbar epidural block, and lumbar sympathetic block for lower extremities. Intravascular regional sympathetic block can be another method of treatment. However, discontinuation of smoking is the most basic and essential treatment for Buerger's disease. We treated 43 Buerger's disease patients with stellate ganglion block and laser therapy. The treatment was not effective for three patients who definitely required amputation.

• The Korean Journal of Pain
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• v.5 no.1
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• pp.85-88
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• 1992

Buerger's disease is a chronic occlusive arterial disease in which a non-arteriosclerotic lesion involves medium-sized arteries, veins, and nerves of the distal leg or arm. Sympathetic interruption is indicated to improve blood flow to the involved extremity, although sympathetic blockade can provide temporally relief of vasospasm and pain. Chemical or surgical sympathectomy has been performed for this purpose and intravenous regional sympathetic block(IRSB) is an alternative. Guanethidine or reserpine has been administered for IRSB. Intraarterial or intravenous systemic administration of prostaglandin E1(PGE1) has been recommended for the treatment of Buerger's disease. We used PGE1 for intravenous regional administration as an IRSB with results as good as that of intraarterial injection. The advantages of the method include that it is less expensive than systemic administration, less invasive than intra-arterial injection, and simple in technical application.

• Journal of Pharmacopuncture
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• v.12 no.2
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• pp.91-98
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• 2009

Objective : The purpose of this case is to show a case of buerger's disease improved by leech therapy. Methods : The patient received Leech Therapy and Oriental medical therapy(acupuncture and herb medicine). Result : We evaluate through visual analog scale(VAS), neuropathic total symptom score(TSS), fontaine grade and picture of patient's foot. Conclusion : Leech therapy and Oriental medical therapy had a good effect on buerger's disease.

• Journal of Chest Surgery
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• v.47 no.2
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• pp.174-177
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• 2014

Surgical revascularization for patients with Buerger's disease is possible only in a few cases, due to the diffuse segmental involvement and the lack of distal runoff vessels available for bypass surgery. We encountered a case of resting pain in the right foot, coldness with dysesthesia, and cyanosis on the right 1st toe. The patient was treated with an endovascular intervention after vein patch angioplasty failed due to an inflammatory reaction of Buerger's disease. We suggest that an endovascular procedure can be an effective treatment, even in addition to more conservative and surgical management, in patients with Buerger's disease and critical limb ischemia.

• The Korean Journal of Pain
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• v.8 no.2
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• pp.286-292
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• 1995

Buerger's disease(Thromboangiitis Obliterans) is characterized by peripheral arterial occlusion of the extremities in young smokers, and leading to ischemia of the tissue and gangrene. Most of these patients suffered from severe pain. therapy for Buerger's disease not enable to undergo reconstructive arterial surgery has been discouraging while multiple modes of analgesics have advanced. Eight subjects who had been operated due to Buerger's disease or diagnosed with this disease were evaluated retrospectively. Continuous epidural block was done at L 2~3 or L3~4 intervertebral space and multiday continuous infusor was connected to epidural catheter. The content of the infusor was clonidine-bupivacaine or clonidine-morphine-bupivacaine mixture. The minimum dose of clonidine was 75 ${\mu}g/day$ and the maximum 450 ${\mu}g/day$. The results were as follows: The analgesia produced by clonidine was superior to any other analgesics. 2) The incidence of the side effects produced by clonidine-bupivacaine mixture were less than that of clonidine-morphine-bupivacaine mixture. 3) Minimum dose of clonidine for the pain relief was required more than 225 ${\mu}g$ per day. From the above results, we recommend that clonidine is an effective agent to provide pain relief for the patients with Buerger's disease.

• Journal of Chest Surgery
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• v.20 no.2
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• pp.261-269
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• 1987

From 1976 through 1986, authors have experienced 127 cases of peripheral vascular surgery which had been done in this department. There were 29 cases of atherosclerosis obliterances including 7 Leriche syndrome, 32 Buerger`s diseases, 25 arterial thromboembolisms, 21 vascular injuries, 2 peripheral arterial aneurysms, 2 renovascular hypertensions, 1 congenital A-V malformation, 13 varicose vein of lower extremities, and 2 Jugular venous ectasia. Cases with vena caval disease and aortic disease were excluded. The mean age of ASO and Buerger`s disease was 56.1 yrs, 33.8 yrs respectively. The male to female ratio showed marked male preponderance [27:2, and 30:2], and almost every male patient was smoker. The indication of operation was similar in both disease entities. The method of operation for ASO were bypass procedure [17], thromboendarterectomy [6], and lumbar sympathectomy [5], and for Buerger`s disease were mainly sympathectomy and few bypass procedures and amputations. Seventeen patients with ASO were followed from 3 to 75 month and overall patency rate for bypass or endarterectomy in one and two months and 2 1/2 yr were 93%, 87%, and 31% respectively. Post operatively patient`s symptoms was relieved or alleviated in almost ASO patients, and about 60% of Buerger`s disease. We concluded that in patient with ischemic limb, we must revascularized aggressively for symptomatic relief. And choice of graft for bypass procedure was to be evaluated further.

• Journal of Acupuncture Research
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• v.21 no.4
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• pp.263-268
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• 2004

Objective: The purpose of this case study is to show a case of ulcer due to buerger's disease improved by conservative acupuncture therapy. Methods : The patient was treated from 29 December, 2003 to 12 April, 2004. The patient received TDP, Infra-Red and Acupuncture therapy. Results: We evaluated through visual analog scale(VAS) and picture of patient's hand. Conclusion: We suggest to treat ulcer resulting from buerger's disease with Acupuncture therapy as a conservative therapy and would like to research acupuncture treatment plan for the further treatment.

• The Journal of Internal Korean Medicine
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• v.44 no.4
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• pp.741-750
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• 2023

Objectives: This study investigated the effects of Korean medicine treatments on Buerger's disease. Methods: From December 27, 2022, to January 16, 2023, we treated Soeumin patients with Buerger's disease admitted to a hospital specializing in Korean medicine. The patient's symptoms included feelings of coldness in the lower extremities, feelings of dullness, and stabbing pain. For treatment, Korean medicine treatments, such as acupuncture, moxibustion, and herbal medications (Sogyeonghwalhyeol-tang granules and Gwangyebujaijung-tang-gami) were administered. The patient's improvement was evaluated using the numerical rating scale (NRS) every day. Lower extremity and foot temperatures were evaluated using digital infrared thermal imaging (DITI). Results: Through the treatment regimen, the patient's NRS scores decreased, and lower extremity and foot temperatures increased. Conclusions: Korean medicine treatments for cold lower extremities, feelings of dullness, and stabbing pain caused by Buerger's disease are potentially effective.

• Journal of Chest Surgery
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• v.41 no.4
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• pp.508-511
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• 2008

The incidence of the Buerger's disease is higher for the far-East Asian population that for western people, but the surgical outcomes have been documented to be unsatisfactory. So, more aggressive and multi-focused treatment modalities should be warranted such as stopping smoking or intravenous vasodilator infusion with surgery. We report here on a successful surgical case of intra-arterial direct infusion of Prostaglandin E1 concomitant with surgical bypass and lumbar sympathectomy to treat Buerger's disease.