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PubMed This is a summary of 17 peer-reviewed journal articles Updated
Vascular Surgery

Building Your Care Team and Preparing for Your First Visit

At a Glance

Managing Buerger disease requires a specialized care team, including a vascular surgeon and smoking cessation specialist. Prepare for your first visit by gathering imaging, lab results, and your complete tobacco history to help your doctors accurately diagnose and treat the condition.

Because Buerger disease is rare and affects multiple aspects of your life—from physical function to professional stability—it cannot be managed by a single doctor. A successful treatment plan requires a multidisciplinary care team [1]. This group of specialists works together to stop the disease’s progression, manage your pain, and protect your limbs.

Building Your Core Care Team

A comprehensive team typically includes the following specialists:

  • Vascular Surgeon or Interventional Radiologist: These are the “plumbers” of your care team. They specialize in restoring blood flow through advanced techniques like endovascular recanalization or surgical bypass [2][3].
  • Rheumatologist: Their role is critical during the diagnosis phase to rule out other “look-alike” autoimmune conditions or systemic vasculitis [4][5].
  • Smoking Cessation Specialist: This is often the most important member of your team. Quitting nicotine cold-turkey is incredibly difficult, and the physical and emotional toll of withdrawal is severe. Because quitting tobacco is the only way to stop the disease, you need professional support from a counselor or program specifically trained in addiction medicine who can offer non-nicotine alternatives and compassionate care [6][1].
  • Podiatrist and Wound Care Specialist: If you have developed ischemic ulcers (sores caused by lack of blood flow), these specialists provide the meticulous care needed to prevent infection and promote healing [7][8].
  • Pain Management Specialist: Buerger-related pain can be intense and persistent. A specialist can help coordinate medications, such as vasodilators, to improve your quality of life [9][10].

Preparing for Your First Appointment

Buerger disease is a “diagnosis of exclusion,” meaning your doctor needs to see everything that has already been tested to ensure the diagnosis is correct [4][11]. Bring physical or digital copies of the following:

  1. Imaging Studies: The actual images (not just the reports) from any angiograms, CT scans (CTA), or MRIs (MRA) on a CD or digital drive [11][12].
  2. Laboratory Results: Complete results for blood tests like ANA, RF, ESR, and CRP, as well as lipid (cholesterol) panels and blood sugar tests [4][13].
  3. Vascular Tests: Reports from your Ankle-Brachial Index (ABI) or any pulse volume recording (PVR) tests.
  4. Tobacco History: A detailed timeline of your tobacco or nicotine use, including any previous attempts to quit and what methods you used [14][15].

Vetting Your Specialist

Since Buerger disease is rare, many doctors may have only seen a few cases in their careers. It is important to ensure your vascular specialist has the specific expertise needed for distal (far-extremity) disease. Buerger disease behaves differently than standard atherosclerosis; for instance, it often doesn’t respond to standard blood thinners or immunosuppressants [16][17]. Asking specific questions about their experience with Thromboangiitis obliterans (TAO) can help you determine if you are in the right hands.

Common questions in this guide

Which doctors treat Buerger disease?
Because it affects multiple systems, Buerger disease requires a team of specialists. Your core care team will typically include a vascular surgeon or interventional radiologist, a rheumatologist, a podiatrist, a pain management specialist, and a smoking cessation counselor.
What should I bring to my first appointment for Buerger disease?
You should bring actual physical or digital copies of your imaging studies, such as angiograms or CT scans, rather than just the written reports. You should also bring complete lab results, vascular tests like an Ankle-Brachial Index, and a detailed timeline of your tobacco use.
Why do I need to see a rheumatologist for Buerger disease?
A rheumatologist is critical during the diagnosis phase to help rule out other autoimmune conditions or types of systemic vasculitis that can mimic Buerger disease. Since Buerger disease is a 'diagnosis of exclusion', these other conditions must be eliminated first.
What questions should I ask a vascular specialist about Buerger disease?
You should ask how many Buerger disease patients they currently manage and their experience with distal revascularization techniques. Because the disease is rare, ensuring they have specific experience with thromboangiitis obliterans is essential for getting the right care.
Why is a smoking cessation specialist important for Buerger disease?
Quitting nicotine is often the most difficult part of treatment, but it is the only way to stop the disease from progressing. A specialist trained in addiction medicine can provide non-nicotine alternatives and compassionate support to help you manage severe withdrawal symptoms safely.

Questions to Ask Your Doctor

Curated prompts to bring to your next appointment.

  1. 1.How many patients with Buerger disease do you currently manage, and what are your typical outcomes for limb salvage?
  2. 2.Given the 'corkscrew' vessels in my hands/feet, do you have experience with distal revascularization techniques specifically for TAO?
  3. 3.Can you help me coordinate with a rheumatologist to definitively rule out other systemic vasculitides?
  4. 4.If I have a flare-up or a new ulcer, what is the protocol for getting an urgent evaluation?
  5. 5.Which smoking cessation programs do you recommend that are familiar with the high stakes of a Buerger diagnosis?
  6. 6.Am I a candidate for Iloprost infusions?
  7. 7.Are my lesions distal enough to confirm Buerger's?

Questions For You

Tap a prompt to share your answer — we'll use it plus this page's context to start a tailored conversation.

References

References (17)
  1. 1

    Demographic Traits, Clinical Status, and Comorbidities of Patients With Thromboangiitis Obliterans in Japan.

    Watanabe Y, Shimizu Y, Hashimoto T, et al.

    Circulation journal : official journal of the Japanese Circulation Society 2024; (88(3)):319-328 doi:10.1253/circj.CJ-23-0211.

    PMID: 37423757
  2. 2

    Immediate and late outcomes of endovascular therapy for lower extremity arteries in Buerger disease.

    Kim DH, Ko YG, Ahn CM, et al.

    Journal of vascular surgery 2018; (67(6)):1769-1777 doi:10.1016/j.jvs.2017.09.020.

    PMID: 29157680
  3. 3

    A systematic review and meta-analysis of early and late outcomes after endovascular angioplasty among patients with thromboangiitis obliterans and chronic limb ischemia.

    Galyfos G, Liakopoulos D, Chamzin A, et al.

    Journal of vascular surgery 2023; (77(5)):1534-1541.e2 doi:10.1016/j.jvs.2022.09.017.

    PMID: 36174815
  4. 4

    Recent Updates and Advances in Winiwarter-Buerger Disease (Thromboangiitis Obliterans): Biomolecular Mechanisms, Diagnostics and Clinical Consequences.

    Fazeli B, Ligi D, Keramat S, et al.

    Diagnostics (Basel, Switzerland) 2021; (11(10)) doi:10.3390/diagnostics11101736.

    PMID: 34679434
  5. 5

    The IL-33/sST2 Axis in Thromboangiitis Obliterans.

    Sharebiani H, Mohareri M, Mirhosseini A, Fazeli B

    Journal of inflammation research 2020; (13()):317-323 doi:10.2147/JIR.S253980.

    PMID: 32765040
  6. 6

    The Effect of Smoking Cessation on the Technical Success of Endovascular Treatment for Thromboangiitis Obliterans.

    Gundogmus CA, Samadli V, Sorkun M, Oguzkurt L

    Journal of vascular and interventional radiology : JVIR 2023; (34(6)):1038-1044 doi:10.1016/j.jvir.2023.02.008.

    PMID: 36791958
  7. 7

    Indocyanine Green Angiography in the Evaluation of Surgical Amputation Level in Patients with Arterial Ulcers Due to Thromboangiitis Obliterans.

    Akyüz S, Güven HE, Yılmaz KB

    Medicina (Kaunas, Lithuania) 2025; (61(9)) doi:10.3390/medicina61091678.

    PMID: 41011069
  8. 8

    Clinical Presentation and Treatment of Thromboangiitis Obliterans With Superimposed Osteomyelitis.

    Kidron A, Daahir C

    Cureus 2022; (14(1)):e21423 doi:10.7759/cureus.21423.

    PMID: 35198328
  9. 9

    [Thromboangiitis obliterans: notions for practice].

    Calanca L, Alatri A, Krieger C, et al.

    Revue medicale suisse 2017; (13(586)):2129-2133.

    PMID: 29211372
  10. 10

    Successful sequential drug eluting balloon angioplasty to chronic total occluded popliteal artery in a patient with thromboangitis obliterans by PCR.

    Kaçmaz F, Kaya A, Yazıcı A

    Anatolian journal of cardiology 2016; (16(6)):450-1 doi:10.14744/AnatolJCardiol.2016.6979.

    PMID: 27282675
  11. 11

    [Thromboangiitis obliterans: an update 2025].

    Stammler F

    Deutsche medizinische Wochenschrift (1946) 2025; (150(23)):1440-1446 doi:10.1055/a-2660-1858.

    PMID: 41213536
  12. 12

    Evaluation of Ultrasound Microflow Imaging as an Assessment Tool for Digital Arteries in Thromboangiitis Obliterans.

    Mohamedi N, Guédon AF, Wang LZ, et al.

    Ultrasound in medicine & biology 2025; (51(9)):1411-1417 doi:10.1016/j.ultrasmedbio.2025.05.001.

    PMID: 40484752
  13. 13

    Thromboangiitis Obliterans Biomarker Shifts in Different Acute Phase Stages: A Case Study.

    Hofmann GA, Zierfuss B, Koppensteiner R, et al.

    Annals of vascular surgery 2021; (73()):509.e5-509.e9 doi:10.1016/j.avsg.2020.11.004.

    PMID: 33333192
  14. 14

    Thromboangiitis obliterans (Buerger's disease).

    Rivera-Chavarría IJ, Brenes-Gutiérrez JD

    Annals of medicine and surgery (2012) 2016; (7()):79-82 doi:10.1016/j.amsu.2016.03.028.

    PMID: 27144003
  15. 15

    Pathogenesis and Management of Buerger's Disease.

    Liew NC, Lee L, Nor Hanipah Z, et al.

    The international journal of lower extremity wounds 2015; (14(3)):231-5 doi:10.1177/1534734615599654.

    PMID: 26264874
  16. 16

    A Non-smoking Woman with Anti-phospholipid Antibodies Proved to Have Thromboangiitis Obliterans.

    Shima N, Akiyama Y, Yamamoto S, et al.

    Internal medicine (Tokyo, Japan) 2020; (59(3)):439-443 doi:10.2169/internalmedicine.3372-19.

    PMID: 31588083
  17. 17

    Pathogenesis of thromboangiitis obliterans: Gene polymorphism and immunoregulation of human vascular endothelial cells.

    Sun XL, Law BY, de Seabra Rodrigues Dias IR, et al.

    Atherosclerosis 2017; (265()):258-265 doi:10.1016/j.atherosclerosis.2017.08.009.

    PMID: 28864202

This page provides educational information on building a care team and preparing for a Buerger disease appointment. It is not a substitute for professional medical advice, diagnosis, or treatment.

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