Thromboangiitis obliterans (Buerger's disease) is caused by vasculitis (inflammation of the blood vessels). The blood vessels of the hands and feet are especially affected, becoming constricted or totally blocked. This reduces blood flow to the hand and foot tissues, resulting in pain and eventually damage. Thromboangiitis obliterans affects about 6 of every 10,000 people. It almost always affects men ages 20 to 40 who have a history of smoking or chewing tobacco.