Prognosis

Buerger disease often involves repeated acute episodes of ischemia over several years. The disease intensifies at 30 to 40 years of age and then regresses. It is rarely present in patients >60 years of age.[62]

Smoking cessation

Patients who continue to smoke have a 19% major amputation rate; this is 2.73 times greater than for people who have ceased smoking, according to one study.[32][34] Smoking increases flare-ups and reduces ulcer healing. A return to smoking following cessation may lead to a flare-up of the disease. Smoking only 1 or 2 cigarettes a day, using smokeless tobacco (chewing tobacco), or using nicotine replacement therapy may all keep the disease active.[19][20] Smoking is best stopped through smoking cessation classes, although varenicline has been shown to be beneficial. Varenicline is a selective nicotinic receptor partial agonist that is used as an aid for smoking cessation.

Amputations

In one study, 34% of patients had an amputation within 15 years of diagnosis.[2] The amputation-free survival rates at 5 and 10 years were 85% and 74%, respectively. Limb infection was associated with an increased amputation rate.[2]

Repeated amputations are often needed and are an indication of the disease severity.

Life expectancy

Life expectancy is not altered in patients with Buerger disease: 90% to 95% survive 10 years; 85% survive 25 years.[1][32][63] This is probably because Buerger disease is not associated with cardiovascular risk factors, aside from smoking.

Use of this content is subject to our disclaimer