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Calciphylaxis: Calcific Angiopathy Resulting in Acral Gangrene

Case Reports

Robert J. Obermeyer, MD

Maria R. Lucarelli

Department of Surgery, Western Reserve Care System, Youngstown, Ohio

Mark K. Hirko, MD

Department of Surgery, Western Reserve Care System, Youngstown; Northeastern Ohio Universities College of Medicine, Rootstown, Ohio

John J. Turner, MD

Department of Surgery, Western Reserve Care System, Youngstown, Ohio

Jeffrey R. Rubin, MD

Department of Surgery, Western Reserve Care System, Youngstown; Northeastern Ohio Universities College of Medicine, Rootstown, Ohio

The role and success of peripheral vascular surgery in patients with end-stage renal disease (ESRD) remains controversial. Reduced survival, higher mortality, and lower limb salvage rates have led some authors to advocate primary amputation in this patient population. Until recently, the explanation for high failure and mortality in these patients could not be explained. The authors report five patients with ESRD initially diagnosed with acral gangrene secondary to calciphylaxis. Despite distal gangrene, only three of the five patients had significant peripheral arterial insufficiency. Poor surgical results in ESRD patients developing peripheral vascular disease (PVD) can sometimes be explained on the basis of calciphylaxis.

Vascular and Endovascular Surgery, Vol. 32, No. 5, 447-453 (1998)
DOI: 10.1177/153857449803200507


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