Blue toe syndrome: Treatment with anticoagulants and delayed percutaneous transluminal angioplasty

M. L. Brewer, M. L. Kinnison, B. A. Perler, R. I. White

Research output: Contribution to journalArticle

Abstract

The spontaneous onset of a painful unilateral blue toe is usually caused by fibrinoplatelet microemboli arising from an upstream stenotic or occlusive lesion of the iliac or femoral artery. This constellation of findings is referred to as the blue toe syndrome (BTS). In 12 patients who experienced 14 spontaneous episodes of BTS, angiography demonstrated 15 proximal atherosclerotic arterial lesions, which were presumed to be the source of the microemboli. Fourteen of the 15 lesions were short-segment stenoses or occlusions distal to the aortic bifurcation. Six lesions were treated with antiplatelet or anticoagulant drugs followed by delayed percutaneous transluminal angioplasty (PTA) 6-12 weeks later. Three lesions were treated with surgical bypass, three with long-term anticoagulation, and one with transcatheter clot aspiration and immediate PTA. Two were treated with immediate thrombolytic therapy and had embolic complications. Anti-platelet and anticoagulant therapy followed by delayed PTA may be an effective alternative to surgery for treating BTS.

Original languageEnglish (US)
Pages (from-to)31-36
Number of pages6
JournalRADIOLOGY
Volume166
Issue number1 I
DOIs
StatePublished - Jan 1 1988

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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