Treatment of Thromboangiitis Obliterans Using Smoking Cessation and Far-infrared Therapy: A Case Study.

Thromboangiitis obliterans (Buerger's disease) is a rare, nonatherosclerotic segmental inflammatory vasculitis that commonly involves small- and medium-sized vessels. Ischemic tenderness impairs patient quality of life and places patients at high risk for amputation. The only definitive known treatment is smoking cessation. Far-infrared (FIR) therapy has shown promising effects on blood flow and healing, but its use in patients with Buerger's disease has not been reported. A 31-year-old man with a 15-pack-year history of smoking, no drug abuse, and no other significant medical history, trauma, or family history diagnosed with thromboangiitis obliterans presented for care at the authors' clinic. Claudication with severe tenderness of both legs and an ischemic ulcer over the right big toe were noted. After surgical debridement of the devitalized tissue, the patient received FIR therapy (5-25 µm, peak at 8.2 µm) applied 25 cm above the surface of the ischemic wound for 40 minutes, 3 times per week. The patient also tapered his smoking. The wound started to heal; granulation tissue was evident and, after 8 weeks, the right lower extremities gradually rewarmed from 24° C to 28° C as measured on the dorsal foot. His pain level decreased from 8 to 5. FIR therapy was continued until the patient stopped smoking (8 months). At the 10-month follow-up visit, the wound had healed completely and resting pain had improved. The results of this case study suggest additional research to explore the potential effects of FIR on patients with thromboangiitis obliterans is warranted.