Reverberation Artifacts Mimicking a Dissection in the Superficial Femoral Artery

We report the case of a 59-year-old asymptomatic patient who presented for follow-up 6 months after recanalization of an embolic occlusion involving the superficial femoral artery (SFA) and the popliteal artery (PA). Duplex ultrasonography revealed a moderate stenosis immediately proximal to the stent entrance, along with a suspected arterial dissection. Closer evaluation identified the stenosis as being due to residual wall-adherent thrombus from the prior intervention, while reverberation artifacts were responsible for the false impression of a dissection. This case underscores the importance of recognizing ultrasound artifacts to prevent diagnostic errors and to avoid misdiagnoses.