Presentation
Characteristic microvascular, ischemic skin findings are present in most cases of CES. [cancertherapyadvisor.com]
Diagnosis is usually (definitely) confirmed with skin or muscle biopsy and fundoscopic examination presenting cholesterol crystals. [escardio.org]
Acute renal failure is present in 25–50% of atheroembolic cases [ 2 ]. [academic.oup.com]
Spontaneous embolization was once the most common presentation. With the increase in endovascular interventions, this ... [accesssurgery.mhmedical.com]
Case Presentation: A 71‐year‐old woman with hypertension presented from an outside hospital for a second opinion. [shmabstracts.com]
Workup
Her urine sediment and vasculitis workup were otherwise unremarkable. There was debate over whether to obtain a biopsy (renal vs. skin) to confirm the diagnosis and whether to continue anticoagulation. [shmabstracts.com]
Echocardiography, a carotid Doppler study, a coagulation profile and a disseminated intravascular coagulation workup were all normal. The patient was started on aspirin, pentoxifylline and heparin. [pancreas.imedpub.com]
Although aortic arch atherosclerosis is common in patients with ischemic stroke, aortography (performed as an add-on to conventional cerebral angiography performed during diagnostic workup of ischemic strokes) frequently fails to identify plaque detected [ahajournals.org]
Treatment
The treatment consists in surgical or percutaneous elimination of the source of embolisation. Medical treatment is mostly symptomatic. [escardio.org]
Although the efficacy of treatment with PGE-1 in renal failure due to CCE has not been reported before, it was effective enough to prevent our patient from requiring haemodialysis. [medicaljournals.se]
If this happens, amputation may be necessary so early treatment is essential. Here we will look at the common symptoms, causes, diagnosis and treatment options for blue toe syndrome. [foot-pain-explored.com]
The overall benefit of the endovascular treatment of AAA is well established. 3-5 There was also the option to perform the renal angioplasty before the aneurysm treatment. [scielo.br]
After treatment, one patient recovered fully and the other two improved significantly. [ntvg.nl]
Prognosis
Prognosis is usually very good in mild forms of the condition where just the toes are affected. In more severe cases, the pain in the toes is disproportional to the degree of blue discolorations. [farinfraredhealth.com]
Mild forms of the disease have a good prognosis and subside without sequelae. However, diffuse multisystemic forms have a very poor prognosis. The kidney is the organ that is most often affected (in approximataly 50 % of cases). [escardio.org]
Gastrointestinal involvement portends a poorer overall prognosis, with 1-year mortality as high as 30-40%. Renal prognosis is highly variable. [cancertherapyadvisor.com]
and 3) a “diffuse multisystemic” form with a very poor prognosis [10]. [pancreas.imedpub.com]
Prognosis Intermittent claudication → good prognosis Rest pain and/or ischemic ulcers → poor prognosis Increased cardiovascular mortality → high risk for secondary MI or stroke A low ABI in PAD is also predictive of an increased risk of all-cause and [amboss.com]
Etiology
Final Notes Treatment of blue toe syndrome depends on the etiology of the disease. [podiatrytoday.com]
The main etiologies are summarized in Table 1. [acrabstracts.org]
Atheroembolism - Cardiac embolism - Hyperviscosity syndromes - Hypercoagulability states - Vasculitis - Miscellaneous What are the most common etiologies of blue toe syndrome - #1 = atrial fibrillation (cardiac embolism) - Leukemias (hyperviscosity [brainscape.com]
ETIOLOGY AND PATHOPHYSIOLOGY The most important risk factor is established atherosclerosis. This is a process in which emboli from proximal lesions (plaque) produce ischemia in distal arterial beds. [accesssurgery.mhmedical.com]
Livedo reticularis, although a classic finding in CES, is a non-specific sign of cutaneous ischemia that may be seen in other disorders of the small arteries (vasculitides) and in shock of any etiology. [cancertherapyadvisor.com]
Epidemiology
Peak incidence : 60–80 years of age Sex : ♂ = ♀ References: [1] [2] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]
Pathophysiology
The blue toe syndrome is the pathophysiological consequence of end-arterial occlusion and frequently the first manifestation of a systemic disorder, such as atheroembolism or vasculitis. Adequate treatment is possible in most cases. [ntvg.nl]
ETIOLOGY AND PATHOPHYSIOLOGY The most important risk factor is established atherosclerosis. This is a process in which emboli from proximal lesions (plaque) produce ischemia in distal arterial beds. [accesssurgery.mhmedical.com]
Pathophysiologically chylomicrons and VLDL have been shown to develop calcium dependent agglutination by C-reactive proteins in acute pancreatitis, which could result in vascular occlusion and resultant infarction [9]. [pancreas.imedpub.com]
Discolouration may affect one foot or both, depending on the underlying pathophysiology. It is often painful and may be associated with claudication. [dermnetnz.org]
Because the pathophysiology does not involve thrombosis, antiplatelet and antithrombotic therapies have no direct role in therapy. Controversy surrounds the decision whether to continue established antithrombotic therapy in patients who develop CES. [cancertherapyadvisor.com]
Prevention
Embolism, Cholesterol Femoral Artery Iliac Artery Toes abstract In patients with severe coronary artery disease and blue toe syndrome, the combination of external iliac ligation and axillary-bifemoral bypass is an effective and durable procedure to prevent [vivo.med.cornell.edu]
Therefore, it is very important to recognise this disorder and its possible causes so as to prevent further episodes of local symptoms and especially systemic complications. Ned Tijdschr Geneeskd. 2007;151:1261-7 [ntvg.nl]
Treatment and Prevention Medical treatment is important and varies depending on the cause. Warfarin, an anticoagulant, is prescribed which clears the blood of clots, if the cause is an embolism. [feetfirstinc.com]
Prevent hand-foot-and-mouth disease It’s contagious, but you can reduce your child’s risk of catching it. Find out what helps. Scabies? Treat everyone! If your child develops scabies, everyone in your household will need treatment. [aad.org]
Although the efficacy of treatment with PGE-1 in renal failure due to CCE has not been reported before, it was effective enough to prevent our patient from requiring haemodialysis. [medicaljournals.se]