The primary focus is to avoid any further ischemia and/or exacerbation of vasospasms.

Positioning – be liberal with you’re use of padding and meticulous in positioning. Keep as much pressure as possible off of affected limbs.

Warm the patient – avoid hypothermia, especially in the affected extremities.

Avoid Invasive monitoring – avoid arterial lines where possible/feasible

Regional anesthesia – generally safe. Epinephrine in local anesthetic is not contraindicated, but should be omitted where possible to avoid further vasospasm/ischemia.

This disease is an inflammatory vasculitis in the extremities. Inflammatory processes lead to vasospasm and occlusion of the vessels.

Symptoms – occlusion of foot, calf, hand, and/or forearm arteries. Symptoms would be consistent with typical ischemia (eg reduced skin temperature, pain, ulcerations, necrosis). Exacerbations (vasospasms) and remissions are common. Stasis of blood during vasospams can lead to venous thrombi. This disease is often associated with Raynauds disease.

Risk Factors – smoking history, Male gender (onset usually before the age of 45)

Diagnosis – Invasive methods include taking a biopsy of the vascular lesions. Noninvasive criteria for diagnosis is based on five criteria: Absence of atherosclerosis risk factors (except smoking), smoking history, onset before age 50, Infrapopliteal arterial occlusive disease, and phlebitis migrans or involvement of the upper limbs.

Treatment – cessation of smoking. There is no proven effective drug treatment.