Power Doppler ultrasonography for positional graft compression after femoral artery reconstruction

Rationale: Vascular reconstruction with autologous vein grafts in musculoskeletal tumors poses biomechanical challenges. Patient concerns: A 35-year-old man developed pain and numbness during deep knee flexion 3.5 years after femoral artery reconstruction using the great saphenous vein. Diagnoses: Power Doppler ultrasonography revealed positional vascular compromise in the reconstructed graft. Interventions: Conservative management with activity modification. Outcomes: Symptoms improved with avoidance of deep flexion; no further progression was noted. Lessons: Dynamic Doppler ultrasonography is a simple, noninvasive method for diagnosing mechanical graft compression after vascular reconstruction.