The patient should be advised to give up smoking since indefinite remissions often follow abstinence from cigarettes. Reduction in smoking is not sufficient.
Pain control is a major problem. Narcotics are usually necessary despite the risk of addiction. Peripheral or sympathetic nerve blocks may provide temporary relief. Cervical or lumbar sympathectomy may be of benefit. Severe, persistent pain may warrant amputation even in the absence of tissue necrosis.
Arterial reconstruction is usually impossible because of the distal nature of the disease. Reconstructions for Buerger's disease also have a higher failure rate than comparable reconstructions for arteriosclerosis.
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