Floating Atheromatous Plaque in the Common Femoral Artery: A Rare Case With Implications for Diagnosis and Management

Floating plaques are well recognized in the carotid artery but are rarely described in the femoral circulation.We present the case of a 73-year-old man with advanced peripheral arterial disease and features of chronic limb-threatening ischemia, including chronic left foot ulceration with a non-healing second-toe ulcer with exposed bone, in the background of prior transmetatarsal amputations and delayed wound healing.A mobile plaque was identified in the left common femoral artery on dynamic B-mode ultrasound, whereas computed tomography angiography showed eccentric calcified stenosis without a definite floating component.The patient underwent femoral endarterectomy with patch repair, and histology confirmed a ruptured calcified atheromatous plaque.Recovery was uneventful, and 12-month follow-up showed no restenosis.This case highlights the diagnostic value of dynamic B-mode ultrasound for detecting mobile femoral atheromatous lesions.