Common femoral artery erosion as a source of thromboembolic acute limb ischemia

Abstract We report a Case of delayed hip prosthetic erosion into the common femoral artery (CFA) three years after implantation. The patient initially presented with left lower extremity acute limb ischemia secondary to a popliteal artery embolism. However, metal artifact around the hip joint prevented CFA evaluation by conventional imaging. Diagnostic angiography with intraoperative intravascular ultrasound (IVUS) revealed CFA dilatation with adherent intraluminal thrombus. Open surgical repair showed hip prosthesis erosion through the posterior wall of the CFA. This report emphasizes a thorough, multimodal embolic work-up, and the usefulness of IVUS as an adjunctive tool for intravascular anatomy evaluation.