What is it about?
It`s the case of a man with blue toe syndrome, who developed bilateral foot ischemia and underwent successful repair of an abdominal aortic aneurysm and associated renal artery stenosis. Blue toe syndrome is characterized by tissue ischemia secondary to embolization of cholesterol crystals or atherothrombotic debris. Microembolization most often occurs in elderly men who undergo an invasive vascular procedure or have an aneurysm.
Featured Image
Why is it important?
The therapeutic goal for blue toe syndrome consists of surgical or percutaneous elimination of the source of embolism. Microembolization most often appears in elderly men who have undergone an angiographic procedure or vascular surgery or even anticoagulant or thrombolytic treatment. The differential diagnosis includes Raynaud's (especially secondary) phenomenon. In blue toe syndrome skin lesions are usually restricted to the occluded artery. Clinical presentation can range from a cyanotic toe or livedo reticularis to a diffuse multiorgan systemic disease that can mimic other systemic illnesses. The kidney is the organ that is most frequently affected (in approximately 50% of cases). In the systemic form prognosis is poor, with a mortality rate of about 70%.
Perspectives
For us it is a better way to perform the renal anastomosis. Relief of the pain in the distal bilateral lower limb was immediately observed. The clinical manifestations of the blue toe syndrome and laboratorial examinations stabilized. The distal lesions need amputation or debridement after delimitation of the necrosis. Medical treatment is mostly symptomatic: rest, warm condition, appropriate dressing, hydration, and organ support when necessary, particularly to ensure renal function. Treatment of pain that is usually disproportionate to the extension of tissue lesion is of most importance.
Professor Paulo Eduardo Ocke Reis
Universidade Federal Fluminense
Read the Original
This page is a summary of: Blue toe syndrome, Jornal Vascular Brasileiro, January 2005, FapUNIFESP (SciELO),
DOI: 10.1590/s1677-54492005000400016.
You can read the full text:
Contributors
The following have contributed to this page
