Page 28 - Virtual Vascular Vol 6
P. 28
Toe Gangrene
nother very delayed presentation of CHRONIC lower limb ischemia in a ne-
Aglected old age home resident. It is too late and not worthwhile to attempt A 59 year old man with insulin dependent diabetes mellitus and end stage renal failure on peri-
salvage of this leg. Many of these patients die of immobility and pneumonia. toneal dialysis presented with 2 months history of gangrene of his right big toe. This is a com-
Long term survival is less than 50% in 5 years. mon presentation of critical ischemia and patients with DM and ESRF are at the highest risk of
limb loss. Diseases are usually distal with calcifications, difficult to revascularize, with elements
of infection.
28 29
