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An Indication for Limb Salvage Surgery

Allastair M. Karmody, MB, ChM, FRCS; Samuel R. Powers, MD; Vincent J. Monaco, MD; Robert P. Leather, MD

Arch Surg. 1976;111(11):1263-1268.

Abstract
• 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)

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

Footnotes
Accepted for publication July 9, 1976.

Read before the 24th scientific meeting of the International Cardiovascular Society, Albuquerque, NM, June 19, 1976.

Reprint requests to Department of Surgery, Veterans Administration Hospital, Albany, NY 12208 (Dr Karmody).

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