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gangrene, ischemic rest pain, ischemic ulcers, Levophed, norepinephrine, toe necrosis, transmetatarsal amputation



  1. Simman, Richard MD, FACS, FACCWS
  2. Phavixay, Laemthong DPM


ABSTRACT: Acute limb ischemia may manifest by ischemic rest pain, ischemic ulcers, or gangrene. Acute arterial occlusion can be the result of emboli from a distant source, acute thrombosis of a previously patent artery, or direct trauma to an artery. Toe necrosis resulting from norepinephrine bitartrate (Levophed; Hospira Inc, Lake Forest, Illinois) is a rare case.