Femoral embolectomy

Why are we operating?

The six-hour operation: open the femoral artery, trawl the clot out with a balloon catheter, and give the leg its blood back before the muscle gives up.

Indication: Acute embolic limb ischaemia; the classically cold, pale, pulseless leg with a source in the heart.

The operation in 4 steps

1. 01Exposing the femoral bifurcation

2. 02Arteriotomy and catheter passes

3. 03Closure and reperfusion

4. 04The fasciotomy question

Danger zones

• Femoral artery

  Every access, every anastomosis, every groin stab wound: this is the vessel in question.

• Femoral vein

  Immediately medial to the artery, the structure a misplaced arterial puncture finds, and the wall of the femoral canal.

• Femoral nerve

  Lateral and OUTSIDE the femoral sheath; retractor injury costs knee extension.