Studies Results Routine laboratory work Within normal limits (WNL) Doppler ultrasound systolic pressures Femoral: 130 mm Hg; popliteal: 90 mm Hg; posterior tibial: 88 mm Hg; dorsalis pedis: 88 mm Hg (normal: same as brachial systolic blood pressure) Arterial plethysmography Decreased amplitude of distal femoral, popliteal, dorsalis pedis, and posterior tibial pulse waves Femoral arteriography of right leg Obstruction of the femoral artery at the midthigh level Arterial duplex scan Apparent arterial obstruction in the superficial femoral artery
With the clinical picture of classic intermittent claudication, the noninvasive Doppler and plethysmographic arterial vascular study merely documented the presence and location of the arterial occlusion in the proximal femoral artery. Most vascular surgeons prefer arteriography to document the location of the vascular occlusion. The patient underwent a bypass from the proximal femoral artery to the popliteal artery. After surgery he was asymptomatic.
1. What was the cause of this patient’s pain and cramping? 2. Why was there decreased hair on the patient’s right leg? 3. What would be the strategic physical assessments after surgery to determine the adequacy of the patient’s circulation? 4. What would be the treatment of intermittent Claudication for non-occlusion?
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