Page 78 - Virtual Vascular Vol 4
P. 78

Subacute Femoral Embolism




     An 88 year old gentleman presented with right calf

     and foot rest pain for ten days. Physical exam found a
     cold right foot. The dorsalis paedis, posterior tibial

     and popliteal pulses were not palpable. Capillary refill
     >2s.


     He had a past medical history of atrial fibrillation but

     recently stopped NOAC due to an episode of upper GI
     bleeding a few months prior.



     Duplex ultrasound showed clots in the distal SFA with
     absence of flow distal to it. In view of the right acute                                                                                    Pre-embolectomy showing dusky
     limb ischaemia, right femoral embolectomy was                                       Thrombus retrieved                                      toes on the right foot

     performed for the patient.










































                                                                                                                                                      Post-embolectomy showing well

                                                                                                                                                      perfused right foot








     A transverse arteriotomy was made over distal common femoral artery.  A Fogarty                                           NOAC was restarted for this patient in view of his acute limb ischaemia
        78
     catheter was inserted to the superficial femoral artery to retrieve the clots.                                            caused by emboli from his AF.                                                                          79
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