title: Bedside ultrasound diagnosis of acute embolic femoral artery occlusion.
abstract: BACKGROUND
  Acute limb ischemia is both a limb-threatening and life-threatening disease process. Nontraumatic acute peripheral arterial occlusion is most commonly caused by a thrombosis or an embolism.
  
  
  OBJECTIVE
  There is limited evidence on the use of bedside ultrasound for the detection of acute limb ischemia, but duplex ultrasonography is standard in the diagnosis and operative planning in chronic limb ischemia. Emergency physicians may use bedside ultrasound in the evaluation of patients with symptoms and signs suggestive of this disease entity.
  
  
  METHODS
  A 64-year-old man with a past medical history of hypertension and an ischemic stroke presented to the Emergency Department with <2 h of severe upper left leg pain that radiated down to his foot. A bedside ultrasound of the left lower extremity was emergently performed. On B-mode ultrasound evaluation, echogenic material was visualized in the left common femoral artery, the artery was noncompressible, and there was an absence of Doppler flow signal. He was then directly taken to the operating room for an emergent limb-saving procedure.
  
  
  CONCLUSIONS
  A focused examination of the aorta, iliac vessels, and femoral artery bifurcation with bedside ultrasonography may help to localize peripheral arterial occlusions and can assist the emergency physician in seeking timely surgical consultation and management.
authors.affiliation: Emergency Ultrasound Division, Department of Emergency Medicine, St. Luke's/Roosevelt Hospital Center, New York, New York; Ronald Reagan UCLA Medical Center, Los Angeles, California.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Rolston
authors.forename: Turandot
authors.initials: T
authors.lastname: Saul
authors.forename: Tommy
authors.initials: T
authors.lastname: Wong
authors.forename: Resa E
authors.initials: RE
authors.lastname: Lewiss
mesh_terms: D000208:Acute Disease; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging*; D004617:Embolism / Q000000981:diagnostic imaging*; D005263:Femoral Artery / Q000648:ultrastructure*; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D019095:Point-of-Care Systems; D014463:Ultrasonography
keywords: Doppler ultrasound; arterial embolus; arterial thrombus; bedside ultrasound; limb ischemia