In order to effectively prevent relapses it is essential to localize and eliminate the source of embolism. Peripheral microembolism is one of the most frequent causes of acute limb ischemia. Pawlaczyk, Katarzyna Gabriel, Marcin Strzelecka-WÄ™klar, Daria A KrasiÅ„ski, Zbigniew Stanisic, Michal Gabriel, Zofia Dzieciuchowicz, Åukasz Adamski, Zygmunt The usefulness of Duplex Doppler ultrasound in the angiological and dermatological diagnosis of patients with blue toe syndrome. Under full-dose intravenous anticoagulation with unfractionated heparin that was switched to oral anticoagulation with vitamin K antagonists (target INR: 2-3) and conservative management of the blue toe the patient made a gradual, but eventually complete clinical recovery over 8 weeks. Further work-up by means of contrast-enhanced MR-A and conventional DSA confirmed a moderate stenosis of the popliteal artery compatible with focal dissection and excluded other causes such as popliteal artery entrapment syndrome. The diagnosis was primarily made by high-resolution duplex ultrasound that revealed a dissection flap (length: 15.5 mm thickness: 0.4 mm) together with the partially thrombosed false lumen at the dorsal wall of the left popliteal artery (degree of local diameter reduction: 56%).
We report a case of a spontaneous dissection of a nonaneurysmal popliteal artery in an otherwise healthy 36-year-old man that came to clinical attention as an acute blue toe syndrome. Spontaneous arterial dissection in peripheral arteries of the extremities is an extremely rare event. Kügler, C F A Poser, M Mosel, F Ruehm, S Rudofsky, G Spontaneous dissection of the popliteal artery in a young man.
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