A track made by organized thrombus after catheter fragment removal mimicking a remnant catheter in the popliteal artery

An 85-year-old man was admitted with claudication of the left leg. He underwent percutaneous intervention 3 months before this admission. Angiography revealed a linear filling defect extending from the left superficial femoral to the popliteal artery, and there was nearly total occlusion of the popliteal artery. Intraprocedural ultrasound confirmed the broken catheter with thrombus filling the popliteal artery (A). The broken catheter was retrieved with a snare, and the entire catheter was extracted. However, the linear echogenic double contour was still visible (B; Video) by ultrasound. Finally, after balloon angioplasty, the contour was no longer apparent (C). Thrombus can change its shape according to surrounding structures and occasionally shows high echogenicity after becoming organized. The highly echogenic surfaces of the remaining pathway mimicked the appearance of a persistent or remnant catheter, leading to the misconception that the catheter fragment remained in place. In such a situation, balloon angioplasty is a good method to disrupt the thrombus. The patient consented to the publication of this report.