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Related Experiment Videos

An institutional experience with arterial atheroembolism

D S Baumann1, D McGraw, B G Rubin

  • 1Department of Surgery, Washington University School of Medicine, St. Louis, Mo.

Annals of Vascular Surgery
|May 1, 1994
PubMed
Summary

Blue-toe lesions indicate unstable plaques and risk of further emboli. Urgent arteriography and surgical intervention can prevent limb loss and recurrent atheroembolism.

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Area of Science:

  • Vascular Surgery
  • Cardiology
  • Dermatology

Background:

  • Blue-toe lesions are cutaneous manifestations of atheroembolic disease.
  • These lesions arise from unstable atherosclerotic plaques, posing risks of recurrent emboli, tissue loss, and mortality.
  • Atheroembolism can affect multiple organ systems, including kidneys and intestines.

Purpose of the Study:

  • To evaluate the clinical presentation, management, and outcomes of patients with cutaneous manifestations of atheroembolic disease.
  • To highlight the association between blue-toe lesions and systemic atheroembolism.
  • To advocate for early diagnosis and intervention.

Main Methods:

  • Retrospective review of 62 patients treated for cutaneous atheroembolism at a single center.

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  • Analysis of patient demographics, risk factors (spontaneous, post-procedural, anticoagulation, trauma), and affected arterial sites.
  • Evaluation of treatment strategies including bypass grafting, endarterectomy, and conservative management.

    • Main Results:

    • 62 patients (mean age 62.8 years) presented with blue-toe lesions.
    • Commonly implicated arteries included the aorta and iliac arteries (80%).
    • Surgical intervention (bypass, endarterectomy) led to limb salvage in 98% of affected limbs with no further atheroembolic events during follow-up.

    Conclusions:

    • Blue-toe lesions are a critical sign of systemic atheroembolism requiring prompt evaluation.
    • Urgent arteriography and surgical correction or bypass of the offending lesion are recommended.
    • Aggressive management can significantly improve limb salvage rates and prevent recurrent atheroembolism.