The internal elastic lamina and media remain intact. Involvement of limb arteries causes forearm, calf, or foot claudication. Severe ischemia of the hand and foot causes rest pain, ulcerations, and skin necrosis. Raynaud's phenomenon occurs frequently, which is indicative of digital artery obstruction. The diagnosis can be supported by arteriography, which reveals interspersed affected and normal segments of blood vessels.
Collateral vessels circumventing sites of occlusion are often present.
The most effective treatment for patients with thromboangiitis obliterans is smoking cessation. The risk of progression to critical limb ischemia and amputation is greater in patients who continue to smoke. Surgical revascularization is not usually an option because of involvement of small distal vessels. There is no established pharmacologic intervention. The use of vasodilator prostaglandins may be beneficial and is under investigation.