スクリュー圧迫部が塞栓源となった急性下腿動脈血栓塞栓症の１例

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  • A Case Report of Acute Crural Arterial Embolization Caused by Thrombus of the Compressed Site of the Popliteal Artery by a Screw.

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We report a case of crural arterial embolization by thrombus formation at the compression site on the popliteal artery by a screw used for a plate (placed to internally fix a displaced femur fracture). A 68-year-old man presented with severe pain of the right lower leg, about 20 years after a placement of a femur plate for the fractured right femur. The dorsalis pedis and posterior tibial pulses were absent with normal popliteal pulses. The patient's right leg presented with pallor, paresthesia, and paralysis. His condition was third degree of the BALAS. The right leg color was improved by first anticoagulant therapy and the posterior tibial pulses became normal. But because it recurred 8 days after the first onset of symptoms, a digital subtraction angiography (DSA) was performed durinng the operation. The DSA revealed thrombus where the popliteal artery was compressed by a screw used for a plate to fix the femur fracture and obstruction of the crural artery. Removal of the screw and a thrombectomy resulted in a symptom-free right lower leg. There are some reports of arterial rupture, obstruction and pseudoaneurysm formation by compression of the artery caused by a screw. We report this uncommon case of acute crural arterial emboli.

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