Education  |   June 2019
Femoral Artery Dissection after Adductor Canal Block
Author Notes
  • From the Department of Anesthesia, University of Toronto, Toronto, Ontario, Canada (L.V., F.W.A.); Department of Anesthesia, St. Michael’s Hospital, Toronto, Ontario, Canada (L.V.); and Department of Anesthesiology and Pain Management, University of Ottawa, Ottawa, Ontario, Canada (F.W.A.).
  • Address correspondence to Dr. Vorobeichik: l.vorobeichik@mail.utoronto.ca
Article Information
Education / Images in Anesthesiology / Cardiovascular Anesthesia / Trauma / Burn Care
Education   |   June 2019
Femoral Artery Dissection after Adductor Canal Block
Anesthesiology 6 2019, Vol.130, 1037-1038. doi:10.1097/ALN.0000000000002627
Anesthesiology 6 2019, Vol.130, 1037-1038. doi:10.1097/ALN.0000000000002627
After an uneventful total knee arthroplasty under spinal anesthesia and ultrasound-guided continuous adductor canal block, the absence of distal pulses was noted in the operative leg. An arterial duplex scan (top image, panel A) demonstrated a femoral artery dissection flap (thin arrow) with a false lumen (thick arrow). Color Doppler demonstrated an absence of arterial flow distal to the dissection (top image, panel B; asterisk). During emergent thrombectomy and arterial repair, a puncture site of the Tuohy needle was noted on the femoral artery (thin arrow; bottom image, panel A), with perivascular hematoma (thick arrow; bottom image, panel A) and an intravascular thrombus (bottom image, panel B). The patient subsequently regained limb perfusion.