Which vessels are primarily affected in patients with thrombangitis obliterans?

Thrombangitis obliterans, also known as Buerger's disease, primarily affects the small to medium-sized arteries and veins, predominantly in the extremities. Specifically, the condition is characterized by occlusive disease affecting the distal arteries in the fingers and toes. This leads to symptoms such as pain, ulceration, and severe ischemia due to the compromised blood flow in these areas.

The involvement of the distal smallest arteries in the digits is a hallmark of the disease, making this answer the most accurate. Understanding that thrombangitis obliterans typically occurs in the context of heavy tobacco use or exposure is crucial; cessation of smoking can significantly alter disease progression.

The other options identify broader or different vascular areas which are not typically the main focus of this condition. While large veins may be involved in other venous disorders and superficial veins or coronary arteries have their own pathologies, they do not characterize thrombangitis obliterans in the same manner as the distal arteries of the digits.