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Saturday, 4 August 2018

CASE 505: LEG ISCHEMIA, Dr PHAN THANH HẢI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.


Man 70 yo in claudication with  pain at right leg and right foot changes in dark skin (photo).


Vascular ultrasound:   
US 1=  normal left femoral artery and vein.


 US 2=  right femoral artery and vein in stenosis.



 US 3=  in middle of right  thigh cannot find out superficial artery.


 US 4= high flow of right dorsalis pedis artery.



Thermography  shows the right leg in hypothermia.



MSCT  angio of the leg arteries:  

CT 1=  big cysts in right/left kidneys and  abdominal aorta with sclerosis plaque.


CT 2=  right  superficial femoral artery is in obstruction. 


CT 3=  small anastomosis at the level of right thigh.


Diagnosis =  obstruction of right superficial femoral artery  with many sites of deep and superficial anastomosis of femoral artery.


DSA  shows  complete obstruction of right superficial femoral artery (DSA 1)



DSA 2 = small anastomosis.


Operation removed blood clot and revascularization of the right leg. Patient remains well recovery.


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