Beware of absent femoral pulse (or how to prevent major complications after minor procedures)

The following is presented to illustrate the importance of examining all peripheral pulses, especially the femoral pulse, before performing minor surgical procedures on the lower extremity, even limited toe amputation. This simple examination is a must in identifying patients at risk for severe peripheral arterial insufficiency, which can lead to major complications if underestimated or undiagnosed. We offer three examples to illustrate this point. All patients underwent successful revascularization and major lower limb amputation was avoided.