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November 1976

"Blue Toe" SyndromeAn Indication for Limb Salvage Surgery

Author Affiliations

From the Department of Surgery, Albany (NY) Medical College and Veterans Hospital.

Arch Surg. 1976;111(11):1263-1268. doi:10.1001/archsurg.1976.01360290097015

• We describe 31 patients in whom proximal lesions in the arterial tree were identified as probable sources of emboli causing the "blue toe" syndrome. This syndrome consists of acute digital ischemia caused by microembolization to the digital arteries from a proximal source via a patent arterial tree, as evidenced by an otherwise well-perfused foot. It is closely analogous to the transient ischemic attacks of the brain, and carries the same potential for serious tissue loss because of repeated embolic showers. The prompt delineation and eradication of the embolic source is of prime importance, in addition to restoration of arterial continuity. Along with the other well-known features of chronic severe ischemia, that is, rest pain, gangrene, etc, the "blue toe" syndrome is therefore an indication for limb salvage surgery.

(Arch Surg 111:1263-1268, 1976)

Crane C:  Atherothrombotic embolism to lower extremities in arteriosclerosis . Arch Surg 94:96-100, 1967.Article
Wychulis AR, Spittell JA, Wallace R:  Popliteal aneurysms . Surgery 68:942-947, 1970.
Sayre GP, Campbell DC:  Multiple peripheral emboli in atherosclerosis of the aorta . Arch Intern Med 100:779-781, 1959.
Hoye SJ, Teitelbaum S, Gore D, et al:  Atheromatous embolization: A factor in peripheral gangrene . N Engl J Med 261:128-131, 1959.Article
Wagner RB, Martin AS:  Peripheral atheroembolism: Confirmation of a clinical concept . Surgery 73:353-359, 1973.
Kaplan K, Millar JD, Cancilla PA:  Atheroembolic renal failure . Arch Intern Med 103:218-221, 1962.Article
Moore WS, Hall AD:  Ulcerated atheroma of the carotid artery . Am J Surg 114:800-802, 1967.Article
Mehigan JT, Stoney RJ: Lower extremity atheromatous embolization. Am J Surg, to be published.
Darling RC, Raines JK, Brener BJ, et al:  Quantitative segmental pulse volume recorder . Surgery 72:873-877, 1972.