False Aneurysm of the Posterior Tibial Artery after Femoral Embolectomy

A 78-year-old lady was admitted with acute ischaemia of her right leg. Her past medical history included atrial fibrillation, multiple admissions for congestive cardiac failure, an exercise tolerance of less than 50 metres and a previous aortic valve replacement (xenograft); she was not on warfarin. Examination revealed a critically ischaemic leg with sensory and motor deficit. No pulse was palpable below the femoral, whilst the contralateral leg pulses were normal. Atrial fibrillation was confirmed on electrocardiogram. After informed consent a femoral embolectomy was performed under local anaesthetic, five hours after the onset of her symptoms. Clot was retrieved from the superficial femoral and profunda arteries with a size four Fogarty embolectomy catheter that passed easily down the superficial femoral to the crural vessels. After the procedure the patient's leg was warm and well perfused with palpable dorsalis pedis and