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[Simpson's atherectomy in embolizing leg artery stenoses]
G Küffer1, R Hansen, F A Spengel
1Klinik und Poliklinik, Universität München.
Insights
Blue toe syndrome, caused by artery micro-emboli, can lead to gangrene. Simpson's atherectomy effectively treated six patients, resolving pre-gangrenous changes without relapse over a ten-month follow-up.
Area of Science:
- Vascular Surgery
- Cardiovascular Medicine
- Dermatology
Background:
- Blue toe syndrome results from atheromatous micro-emboli to digital arteries.
- It presents as painful cutaneous necroses and risk of digital gangrene.
- Urgent intervention is necessary to prevent limb loss.
Purpose of the Study:
- To evaluate the efficacy of Simpson's atherectomy in treating blue toe syndrome.
- To assess the long-term outcomes and recurrence rates following the procedure.
Main Methods:
- Six patients with unilateral blue toe syndrome were treated.
- Simpson's atherectomy was performed on proximally situated femoropopliteal stenoses.
- Angioscopy and histological examination identified emboli as fibrino-platelet thrombi.
Main Results:
- All six patients experienced complete healing of pre-gangrenous digital changes post-treatment.
- A mean follow-up period of ten months showed no recurrence of symptoms.
- Embolic material was visualized with angioscopy and confirmed histologically.
Conclusions:
- Simpson's atherectomy is a successful treatment for blue toe syndrome.
- The procedure effectively resolves digital ischemia and prevents gangrene.
- Long-term outcomes are favorable with no observed relapses.
Abstract:
We report on the treatment and follow-up of six patients with an unilateral "blue toe" syndrome. This is caused by atheromatous micro-embolisation to the digital arteries and requires urgent attention due to the painful cutaneous necroses and impending digital gangrene. In all patients, Simpson's atherectomy of proximally situated femoropopliteal stenoses caused the pre-gangrenous digital changes to heal completely. In a mean observation period of ten months no relapse occurred. The embolising material was presumably parietal fibrino-platelet thrombi which could be observed with angioscopy and were regularly detectable histologically in the excised tissue.