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An Enigma

Jack H. M. Kwaan, MD; John E. Connolly, MD

Arch Surg. 1977;112(8):987-990.

Abstract
• Fifteen patients with peripheral atheroembolism were studied and followed up for from one to three years. Clinical recognition of this condition is often masked by its elusive presentation. Foot pain may be the very earliest symptom. Transient presentation is an important feature. Eventually, gangrene develops in the toes. Ankle pulses are present on physical examination. Both aortography showing proximal ulcerative plaques and digital arteriograms revealing the sharp cutoff pattern of an arterial embolus provide diagnostic confirmation. The results of treatment were satisfactory in all instances following aortoiliac endarterectomy or Dacron graft interposition. In five patients with gangrenous changes, toe amputation was necessary.

(Arch Surg 112:987-990, 1977)

Author Affiliations
From the Department of Surgery, University of California at Irvine and the Veterans Administration Hospital, Long Beach, Calif.

Footnotes
Accepted for publication March 9, 1977.

Read before the annual meeting of the Southern California Chapter of the American College of Surgeons, Palm Beach, Calif, Jan 14, 1977.

Reprint requests to Department of Surgery, University of California at Irvine, Irvine, CA 92717 (Dr Kwaan).

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