Current status of thromboangiitis obliterans (Buerger's disease) in Japan.

We analysed clinical features and outcome in 850 patients with thromboangiitis obliterans (TAO), based on the 1993 Nationwide Survey of Vasculitis database collected from 3722 clinical sites in Japan. The survey was designed to assess clinical manifestation categorized by Fontaine's classification, distribution of lesions (arterial involvement and migratory superficial phlebitis), response to medical and surgical treatment, and outcome. There were 771 males (90.7%) and 79 females (9.3%), with a mean age of 50.8+/-0.4 (range: 17-81) years. Clinical manifestations at the first consultation were Fontaine I in 8.0%, Fontaine II in 29.6%, Fontaine III in 23.9%, and Fontaine IV in 38.1%. These symptoms had been significantly improved by the time of survey. Ulcer formation in the past history had occurred in 45.2%, which was the most common in toes (85.9%). Failure of smoking cessation significantly affected the risk of ulcer formation (odds ratio=1.71, 95% CI=1.19-2.47; P=0.004) and amputation (odds ratio=2.73, 95% CI=1.86-4.01; P<0.0001). Clinical features in female patients with TAO were equal to those in male patients, except for the fact that non-smokers were more common in female patients. Abstinence from tobacco significantly reduces the risk of ulcer formation and amputation, and thus improves the quality of life in patients with TAO.