It is confirmed when The ankle-brachial index (ratio of ankle to arm systolic blood pressure) for legs or segmental pressures for arms indicates distal ischemia Echocardiography excludes cardiac emboli Blood tests (eg, measurement of antinuclear antibody, rheumatoid factor, complement, anticentromere antibody, anti-scleroderma [SCL] 70 antibody) exclude vasculitis Tests for antiphospholipid antibodies exclude antiphospholipid antibody syndrome (although these levels may be slightly elevated in thromboangiitis obliterans) Angiography shows characteristic findings (segmental occlusions of the distal arteries in the hands and feet, tortuous, corkscrew collateral vessels around occlusions, and no atherosclerosis) Treatment of Thromboangiitis Obliterans Smoking cessation Local measures Sometimes drug therapy Treatment is cessation of tobacco use.