Thromboangiitis obliterans (Buerger disease) is caused by small blood vessels that become inflamed and swollen. The blood vessels then narrow or become completely blocked by blood clots (thrombosis). Blood vessels of the hands and feet are especially affected. Arteries are more affected than veins. Average age when symptoms begin is around 35. Women and older adults are affected less often. This condition mostly affects young men ages 20 - 40, who are heavy smokers or chew tobacco. Only 1 of 10 patients are women. Many patients also have very poor dental hygiene, likely due to tobacco use.

Symptoms based on different phases of syndrome in TCM
First phaes (inadequate blood flow): numbness in the affected areas, hands or feet may feel cold, intermittent claudication, repeated wandering phlebophlogosis, pale colour and lustre.
Second phase (dystrophia): Symptoms gets worse, intermittent claudication, persistent rest pain, hands or feet may be pale, red, or bluish, shank amyotrophy.
Third phase: (necrosis): Symptoms keep on getting worse, black toe in the affected area, gangrene, formation of ulceration, persistent severe aches.
Note: Symptoms may worsen with exposure to cold or with emotional stress. Usually, two or more limbs are affected.