Thromboangiitis Obliterans (Buerger’s Disease)—Current Practices

Table 4

Diagnostic criteria.

SHIONOYA criteria [44]	OLIN criteria [45]
Onset before age 50	Onset before age 45
Smoking history	Current (or recent past) tobacco use
Infrapopliteal arterial occlusions upper limb involvement or phlebitis migrans	Distal extremity ischemia (infrapopliteal and/or intrabrachial), such as claudication, rest pain, ischemic ulcers, and gangrene documented with noninvasive testing
Absence of atherosclerotic risk factors other than smoking	Laboratory tests to exclude autoimmune or connective tissue diseases and diabetes mellitus
	Exclude a proximal source of emboli with echocardiography and arteriography
	Demonstrate consistent arteriographic findings in the involved and clinically noninvolved limbs

A biopsy is rarely needed to make the diagnosis unless the patient presents with an unusual characteristic, such as large artery involvement or age greater than 45 years.