Trash foot

This may occur as a complication of an interventional procedure e.g. aortic aneurysmal surgery, coronary catheterization. It is caused by the lodging of distal emboli that may cause infarction of the whole foot.

• trash foot - triad of thigh and foot pain, livedo reticularis, and intact peripheral pulses is considered to be pathognomonic for cholesterol embolisation

Diagnosis

• laboratory tests that may aid in the diagnosis of cholesterol emboli syndrome include eosinophilia, eosinophiluria, increased sedimentation rate, and decreased complement concentrations

Treatment:

• multiple treatment regimens have been generally unsuccessful in altering the course of the disease process
  • most significant impact on the disease can be made by its prevention
  • thrombolytic and anticoagulant treatments are not indicated and only supportive care for such symptoms as hypertension, ulceration, and gangrene is advocated (1)
• amputation of affected lower limb may be necessary; an end-diastolic pneumatic boot has been used as an alternative to amputation (2)

Reference:

• Heart 2003;89:e17 (http://www.heartjnl.com/cgi/content/full/89/5/e17)
• Filip JR, Dillon RS.Treatment of end-stage "trash feet" with the end-diastolic pneumatic boot. Angiology. 2008 Apr-May;59(2):214-9