Successful management of upper limb Buerger's disease with video-assisted thoracoscopic sympathectomy: a case report

Introduction: Buerger's disease (BD) is an inflammatory disorder that specifically targets small- and medium-sized arteries in the extremities, resulting in pain. Despite the limited efficacy of many medicinal treatments, surgical interventions, such as video-assisted thoracoscopic sympathectomy (VATS), are frequently utilized. Case description: A 45-year-old male with a significant smoking history presented with recurring finger pain, bluish discoloration, and widespread ulcerations in the fourth digit of the left hand. The findings of Allen's test were positive as well. The patient fulfilled the diagnostic criteria for BD according to the VAS guidelines, with one major criteria (a history of active smoking) and four minor criteria (beginning of the disease before the age of 45, upper limb ischemia, migratory thrombophlebitis, and discoloration of the fingers). The choice to proceed with VATS was made because the symptoms persisted after oral medicine was administered. Conclusion: This therapy effectively treats BD and significantly reduces symptoms associated with insufficient blood flow. The ability of VATS to control sympathetic dysfunction suggests that it is a valuable treatment option.