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GENERAL ATHEROSCLEROSIS, ARTERIOSCLEROSIS OBLITERANS OF THE LOWER EXTREMITIES

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

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