COMMON FEMORAL ARTERY THROMBOEMBOLISM

A 75 y female developed acute left lower limb pain with burning sensation . On examination the limb was cold with slight bluish discolouration of toes. Femoral pulse was feeble, & popliteal , posterior & anterior tibial , & dorsalis pedis pulses were not appreciable . Patient had attack of atrial fibrillation few days back . So , Clinically thromboembolism suspected of cardiac origin . Pt was hypertensive also .

AT Color Doppler - Left external iliac artery showed low velocity biphasic thump / short spectrum- s/o forward flow obstruction ( fig 1 ) . The left common femoral artery showed a Color & spectral signal void , with its lumen occluded by inhomogenically echogenic material s/o thrombosis ( fig 2&3 )  . The thrombus seen at bifurcation with partly extending into just proximal segments of SFA & DFA ( fig 4 ). Rest of arteries were collapsed with trace flow. 

The pt was then subjected to emergency surgical thromboembolectomy of femoral artery & recovered a large thromboembolus ( see fig -5&6)

Fig 1- Dual spectral doppler images with right EIA flow normal , & left EIA flow being short reduced spectrum s/o forward flow obstruction 

Fig2- Color Doppler scan of left common femoral artery showing intraluminal thrombosis ( Color void - arrows )

Fig3- Left common femoral artery shows spectral void 

Fig 4- Color Doppler scan shows thrombus extending into just proximal part of SFA & DFA

Fig 5- Sutured femoral artery after embolectomy. 

Fig 6- Post surgical embolectomy specimen recovered from femoral artery 

PS - 1) The case study is intended for medical professionals for academic purposes only.

 2) Thanks to Dr Anoop Gupta, cardiologist , at Sterling Hospital- Ahmedabad for feedback.