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Letter
Spinal cord stimulation in Buerger's disease
  1. A V Pace1,
  2. N Saratzis2,
  3. D Karokis1,
  4. D Dalainas2,
  5. G D Kitas1
  1. 1Department of Rheumatology, Dudley Group of Hospitals NHS Trust, UK
  2. 21st Department of Surgery, AHEPA University Hospital, Thessaloniki, Greece
  1. Correspondence to:
    Dr G D Kitas, Department of Rheumatology, Dudley Group of Hospitals NHS Trust, The Guest Hospital, Tipton Road, Dudley, West Midlands DY1 4SE, UK;
    g.d.kitas{at}bham.ac.uk

https://doi.org/10.1136/ard.61.12.1114

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    Buerger's disease (BD) is characterised by segmental inflammation of medium and small size arteries, affects mainly young adult men, and is more prevalent in the southeast Mediterranean and the Far East. Its pathogenesis remains unclear, but cigarette smoking is strongly implicated. Autoimmune diseases, hypercoagulable states, diabetes, and emboli need exclusion before a diagnosis is made. The tibial and leg digital arteries are usually affected, and arteriography shows typically “corkscrew” peripheral obstructions. The best treatment is stopping smoking. Prostacyclin infusion is currently the most effective treatment for pain control and healing of ischaemic lesions.1 In selected cases, regional guanethidine block may have good results.2 Sympathectomy does not always provide longstanding benefit,3 and arterial bypass is …

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