Hyperbaric Oxygen Therapy as a Salvage Therapy for the Treatment of Refractory Buerger's Disease (Thromboangitis Obliterans): A Case Report

Thromboangitis obliteran (Buerger's disease) is a non-atherosclerotic, inflammatory peripheral vascular disease of unknown cause. By the previous studies, this disease was noted to be related to long-term smoking and could be improved after cessation of smoking. Recently, autoimmune associated pathogenesis was proposed and there was still no effective medication for this disease. We reported a case of 44 y/o man with Buerger's disease, diagnosed in September 2003 with manifestation of digital gangrene of fingers. Digital gangrene progressed with right index finger amputated in spite of cessation of smoking, parenteral prostaglandin, immunosuppressive, and anticoagulant therapy. After hyperbaric oxygen therapy was given, digital gangrene improved. Angiography was performed before and after hyperbaric oxygen therapy and showed significant improvement of vascular patency. Since there is no consensus for the treatment of refractory Buerger's disease, hyperbaric oxygen therapy may be used as a primary treatment for refractory Buerger's disease.