Unifying Concepts

Diagnostic Criteria for Thromboangiitis Obliterans (Buerger’s Disease)

Since specificity of Buerger’s disease is characterized by peripheral ischemia of an inflammatory nature and with a self-limiting course, diagnostic criteria should be discussed from clinical of view.

Several different criteria have been proposed for the diagnosis of thromboangiitis obliterans:

Diagnostic Criteria of Shionoya:

  • Smoking history;

  • Onset before the age of 50 years;

  • Infrapopliteal arterial occlusions;

  • Either arm involvement or phlebitis migrans;

  • Absence of atherosclerotic risk factors other than smoking.

Diagnostic Criteria of Olin

  • Age younger than 45 years

  • Current or recent history of tobacco use

  • Presence of distal extremity ischemia indicated by claudication, pain at rest, ischemic ulcers or gangrenes, and documented by non-invasive vascular testing;

  • Exclusion of autoimmune diseases, hypercoagulable states and diabetes mellitus;

  • Exclusion of a proximal source of embolization by echocardiography and arteriography;

  • Consistent arteriographic findings in the clinically involved and noninvolved limbs




  1. Olin JW. Thromboangiitis obliterans (Buerger’s disease). N Engl J Med. 2000 Sep 21;343(12):864-9. [Medline]

  2. Shionoya S. Diagnostic criteria of Buerger’s disease. Int J Cardiol. 1998 Oct 1;66 Suppl 1:S243-5. [Medline]


Created: Jun 12, 2006

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