Digital ischaemia and palpable pedal pulses.

Area of Science:

• Vascular Medicine
• Diagnostic Challenges in Ischemia

Background:

• Digital ischemia in non-diabetic patients poses diagnostic difficulties due to intermittent symptoms.
• Evaluation of patients with digital ischemia requires identifying underlying causes beyond diabetes.

Purpose of the Study:

• To investigate the causes of digital ischemia in non-diabetic patients.
• To assess diagnostic methods and treatment outcomes for this condition.

Main Methods:

• Retrospective evaluation of 80 non-diabetic patients presenting with digital ischemia.
• Inferred micro-embolization from cardiac or arterial sources.
• Diagnostic workup included malignancy screening and Indium platelet scanning.

Main Results:

• Micro-embolization (cardiac or arterial) identified in 62/80 patients.
• Malignancy, primarily visceral cancer, diagnosed in 14/18 remaining patients.
• Indium platelet scanning showed aggregation in 14/26 patients; laboratory coagulation/platelet tests were abnormal in only 6.

Conclusions:

• Micro-embolization and malignancy are key causes of digital ischemia in non-diabetics.
• Surgical or medical (anticoagulation/antiplatelet) therapies showed positive outcomes for many patients.