Blue Toe Syndrome Clinical. Experiences of 10 Cases / 日本心臓血管外科学会雑誌

ABSTRACT

The sudden development of cyanotic lesions on the foot and toes may be a result of atheroembolic disease referred to as “blue toe syndrome”. During the last 7 years, 10 patients, consisting of 7 men and 3 women, were treated for ischemia of the toes of varied severity. The patients' ages ranged from 58 to 85 years (mean 73 years). Five patients had lesions on both legs and 5 on one leg. Contrast-enhanced abdominal CT scan revealed atherosclerotic changes of the abdominal aorta concomitant with intramural thrombus in every examined case. Four patients were treated medically and 4 underwent surgery consisting of replacement of the abdominal aorta in 3 and minor amputation of the toes in the other case. Two other patients developed acute renal failure within two months after the diagnosis of blue toe syndrome and succumbed to either heart failure or bleeding peptic ulcer. Contrast-enhanced CT scan is important for the diagnosis of blue toe syndrome. Though the prognosis of patients with blue toe syndrome is good in most cases, multiple microembolization to the viscera may cause renal failure and the prognosis of those patients is less favorable. Surgical intervention should be considered if the blue toe syndrome patient has an abdominal aortic aneurysm or history of multiple embolic episodes.