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Necrosis |
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During the inspection, attention should be paid to discolorations of the skin (especially paleness), temperature, mycoses of the nails, and destruction of tissue. Stage IV of PAD and / or critical ischemia is characterized by the appearance of spontaneous cases of necrosis, mostly in the area of the toes, the front part of the foot, or the heels. These are caused primarily by a PAD, whose origin can be determined by objective methods (Doppler, duplex, angiography). Necroses can arise owing to a trauma or accompanying ailments (e.g. chronic venous insufficiency) in stage I and II as well. These have a clearly better prognosis and are called a complicated stage I or complicated stage II.
In principle, in stage IV an indication of lumen opening measures becomes apparent. In the acral pulse curve, we find a clearly restricted acral circulation. |
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