Buerger's disease and cigarette smoking in Bangladesh.

Buerger's disease is rare in the West but common in parts of Asia and the Middle East. A total of 39 patients with Buerger's disease were investigated in the setting of a hospital in Bangladesh. All but one were male and the mean age at onset of symptoms was 34 years. All but two were current smokers with a mean duration of smoking history of 17 years before the onset of symptoms. No other risk factors were identified. The majority of patients had ulceration or gangrene at presentation, and all but one had palpable femoral pulses. Vascular reconstruction was not possible in this institution and the main treatment options adopted were antibiotics, analgesia, chemical sympathectomy and amputation.