A 34 year old chronic smoker presents to you with progressive claudication of the left arm with ulcers on the ring finger. The patient also gives history suggestive of recurrent superficial phlebitis. There is also history of Raynaud's phenomenon. What is the best treatment for the patient?
High-Yield Explanation
The triad of claudication, Raynaud's phenomenon and migratory superficial thrombophlebitis in a young male smoker is typical of thromboangiitis obliterans (Buerger's disease). An aeriography will show segmental occlusion with collaterals. Histopathology will show sharply segmental acute and chronic vasculitis of small and medium aeries of the affected area. Ref: S. Das, Edition 5, Page 68