Buerger's disease: a 10-year experience in Tehran, Iran

The clinical spectrum of Buerger's disease (TAO; thromboangiitis obliterans) seems to be changing. Considering the lack of any formal studies on the epidemiology of this disease in Iran, we evaluated the data of 198 confirmed cases of TAO during the period 1996-2006. Diagnosis was based on Papa's scoring system. All patients were male and aged at the time of diagnosis 40.5 +/- 10.1 years. All patients were smokers for a duration of 22.2 +/- 11.6 years. There was a strong seasonal variation for admission with winter admissions being significantly the most common (P < 0.001). Patients, 181 (91.4%), had only lower limb involvement, 4 (2.0%) had solely upper limb disease, and 13 (6.6%) suffered from both. Sympathectomy, amputation, and bypass graft surgery were performed in 97 (49.0%; lumbar: 92, thoracic: 5), 71 (35.9%), and 28 (14.1%) patients, respectively. The present report is the second one to show seasonal variation in TAO.