Perioperative point-of-care ultrasound for diagnosis of acute lower extremity arterial thrombosis after total hip arthroplasty revision: a case report

Purpose Acute arterial thrombosis after hip arthroplasty is a rare event associated with potentially catastrophic complications. Early clinical diagnosis of progressive limb ischemia is often difficult in the immediate postoperative period because of residual neuraxial blockade and the nonspecific nature of signs. We describe the use of point-of-care ultrasound (POCUS) in the postanesthesia care unit (PACU) to diagnose this complication early and facilitate timely intervention. Clinical features A 78-yr-old female patient underwent elective right hip revision arthroplasty under spinal anesthesia and postoperatively had an absent dorsalis pedis pulse on her operative leg as screened by an audibleonly Doppler. No obvious clinical symptoms were present as the patient was still under subarachnoidal blockade. A bedside POCUS vascular evaluation was performed in the PACU and showed an absence of blood flow in the superficial femoral artery, expediting the confirmation of athrombectomie ouverte re ' ussie et s'est re ' tablie sans incident apre`s l'ope ' ration. Conclusion Notre pre ' sentation de cas met en e ' vidence l'utilisation innovante et l'impact de l'e ' chographie cible ' e pour e ' valuer la pre ' sence ou l'absence du flux sanguin arte ' riel distal et, dans ce cas, le niveau de l'occlusion arte ' rielle.

Automated summary

This article discusses the use of point-of-care ultrasound in the postanesthesia care unit to diagnose acute arterial thrombosis after hip arthroplasty early and emphasizes the importance of this technique in facilitating timely intervention.