Blue toe syndrome--a rare but possible complication of anticoagulant therapy
Varis, J.; Kuusniemi, K.; Heiro, M.; Järveläinen, H.
Duodecim; Laaketieteellinen Aikakauskirja 127(11): 1154-1157
2011
ISSN/ISBN: 0012-7183 PMID: 21755807 Document Number: 653474
Cholesterol microembolization syndrome (CMS) is a multiorgan ischemic disorder resulting from occlusion of small vessels by cholesterol crystals that are derived from atherosclerotic plaques of major arteries. Flow distribution of cholesterol crystals determines the clinical picture of CMS. Cholesterol crystals distributed to the lower extremities cause a typical "blue toe" appearance. The predisposing factors of CMS include various vascular procedures that scratch the luminal surface of the vascular wall and make the release of cholesterol crystals from the atherosclerotic plaques possible. However, CMS can also occur as a consequence of continuous anticoagulant use. Therefore, patients on anticoagulant therapy complaining even minor toe symptoms should be examined for possible CMS.