Man, born in 1951 sought medical help in the surgery department with complaints of pain in the right leg and the appearance of a lesion on the 5th toe of his right foot. After examination, the surgeon referred him for a vascular ultrasound.
Ultrasound signs of: GENERAL ATHEROSCLEROSIS, ARTERIOSCLEROSIS OBLITERANS OF THE LOWER EXTREMITIES, THROMBOTIC OCCLUSION OF THE SUPERFICIAL FEMORAL ARTERY AND ANTERIOR TIBIAL ARTERY.
Scan Log: Common femoral artery: anatomically correct localization, topography unchanged; vascular patency is normal; venous wall structure is atherosclerotic. intima-media thickness is 1.4 mm (normal up to 1.0 mm). Peak systolic velocity = 61.6 cm/sec. Doppler- modified flow type; multiple atherosclerotic plaques with height of 3-4 mm, which cover the lumen by 40-50%, located mostly on the posterior medial wall.
Deep femoral artery: anatomically correct localization, topography unchanged; vascular patency is normal; venous wall structure is atherosclerotic. Peak systolic velocity = 47.2 cm/sec. Doppler- modified flow type; atherosclerotic plaques not found, no turbulence zone.
Superficial femoral artery: anatomically correct localization, topography unchanged, patency broken in lumen by hypoechoic blood clot, thrombus is at a distance of 15 mm from the bifurcation; venous wall structure is atherosclerotic. Blood flow is not registered. In the middle third of the superficial femoral artery a powerful muscular collateral goes into the artery with collateral blood flow, peak systolic velocity = 45.1 cm/sec.
Popliteal artery: anatomically correct localization, topography unchanged; ; vascular patency is normal; venous wall structure is atherosclerotic. Peak systolic velocity = 13.6 cm/sec. Doppler- collateral blood flow.
Posterior tibial artery: anatomically correct localization, topography unchanged; vascular patency is normal; venous wall structure is atherosclerotic. Peak systolic velocity = 19.0 cm/sec. Doppler- collateral blood flow.
Anterior tibial artery: anatomically correct localization, topography unchanged; patency broken throughout; venous wall structure is atherosclerotic. Blood flow is not registered.
Recommended: Consultation with vascular surgeon, cardiologist, coagulation profile.
Figure 1: Blood clot in the superficial femoral artery at the site of bifurcation video - blood clot in the superficial femoral artery at the site of a bifurcation
Figure 2: Thrombosed superficial femoral artery
Figure 3: Blood clot in the superficial femoral artery at the site of a bifurcation
Figure 4: Collateral in the lower third of the thigh in the pool of the superficial femoral vein
Figure 5: Pulsed-wave Doppler, speed in collateral is 45 cm/s
Figure 6: Pulsed-wave Doppler, collateral, the appearance of blood flow below the thrombosis at the confluence of the collateral in the superficial femoral artery, speed of 30.4 cm/s
12.07.2016