Femoral artery occlusion following pelvic cancer surgery

Acute arterial occlusion in the lower extremities of patients with gynecologic cancers may not be immediately recognized in the postoperative period, despite the known risk of hypercoagulability associated with malignancy. Such delays in recognition and treatment can result in irreversible but potentially preventable tissue injury. This report describes three cases of acute arterial occlusion of the femoral and/or external iliac arteries in the immediate postoperative period following radical pelvic surgery. Two patients lost the involved limb due to irreversible changes resulting from prolonged ischemia. One patient was diagnosed while the involved limb was still viable and surgical revascularization was successfully performed. These cases illustrate the potential morbidity in unrecognized acute limb ischemia and the case with which it may be overlooked. Systematic documentation of arterial patency is recommended in the postoperative period, noting peripheral pulses and patient complaints related to the lower extremities. Rapid diagnosis and surgical intervention significantly increase the chance of maintaining viability of the involved limb.