Peripheral atheroembolism: an enigma.

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 examinations. 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 wiht gangrenous changes, toe amputation was necessary.