Blue toe syndrome: Treatment with percutaneous atherectomy

B. L. Dolmatch, K. S. Rholl, L. B. Moskowitz, M. D. Dake, A. Van Breda, J. O. Kaplan, B. T. Katzen

Research output: Contribution to journalArticlepeer-review

24 Scopus citations


'Blue toe syndrome' refers to digital ischemia of the foot in the presence of palpable or Doppler audible pedal pulses. This clinical syndrome is caused by microembolization to small vessels from a proximal source. The use of percutaneous transluminal atherectomy is described in the treatment of embologenic superficial femoral artery lesions in seven patients. All seven had prompt healing of the ischemic toes, and none required surgical revascularization or amputation. One patient developed a recurrent stenosis at the atherectomy site and had a second episode of digital ischemia, which was treated by means of atherectomy with a larger device. Histologic study of artherectomy specimens suggests that emboli arise from adherent fibrinoplatelet aggregates or thrombus and less often from cholesterol-rich atheromatous plaque. Although either percutaneous transluminal angioplasty or atherectomy can be used to treat the underlying stenosis, percutaneous atherectomy offers the advantage of nonsurgical removal of embologenic material and provides material for histologic study. Percutaneous atherectomy is an effective method of treating embologenic superficial femoral stenoses in patients with ipsilateral blue toe syndrome.

Original languageEnglish (US)
Pages (from-to)799-804
Number of pages6
Issue number3
StatePublished - 1989


  • Arteries, extremities
  • Arteries, stenosis or obstruction
  • Artherectomy
  • Embolism
  • Fingers and toes, ischemia

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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