Acute arterial occlusion in the midpiece of femoral artery following total knee arthroplasty: Report of one case

Abstract

Acute arterial occlusion is a rare complication following total knee arthroplasty (TKA). The incidence as reported previously is from 0.03% to 0.17%; however, the sequelae can be disastrous because of its potential threat to limb loss.We report a case of acute arterial occlusion in the midpiece of femoral artery following TKA occurred 40 min postoperatively. The occlusion site existed at the midpiece of femoral artery is uncommon. Arterial circulation of the lower limb could not be restored by the thrombolysis and thrombectomy treatments performed within 11 h after TKA. In the end, amputation had to be carried out. In the treatment of acute arterial occlusion following TKA with a tourniquet, it is important to fully consider that arteriosclerosis may induce atheromatous plaque disruption, which might be the reason for acute arterial occlusion.

Fig. 1

The femoral artery angiogram demonstrated complete occlusion with abrupt cutoff of the left femoral artery above the adductor magnus tendon hiatus furcation, 8 h after total knee arthroplasty in the left knee.

Fig. 2

When the catheter passed the occlusion site, angiogram showed that there was no occlusion in the inferior segment of the femoral artery and the popliteal artery; the flow of contrast medium was unobstructed.

Fig. 3

The catheter could be introduced against the artery tunica intima smoothly past the occlusion site in the distal and proximal direction in the procedure of the femoral artery angiogram.