Introduction: Atrial fibrillation is a common arrhythmia that can be associated with a high risk of thromboembolic complications. Ischemic stroke due to involvement of the cerebrovascular circulation is the most common of these complications. Peripheral emboli may not be as easily recognized and the data regarding their risk, incidence and diagnosis is limited.
Case Report: A 46-year-old female presented with exertional dyspnea and right leg pain. Her rhythm was atrial fibrillation. Echocardiogram showed a large left atrial mass and computed tomography angiogram demonstrated filling defects in the left atrium and in the superior mesenteric artery. A peripheral angiogram showed occlusion of the right popliteal artery. The patient underwent right popliteal arterial thrombectomy and excision of the left atrial mass, which was found to be an organized thrombus. Anticoagulation was initiated and continued after discharge.
Conclusion: Peripheral emboli may account for 10–20% of embolic events related to atrial fibrillation. They are associated with significant morbidity and mortality and may often go unrecognized unless a high index of clinical suspicion is present. These patients are at high risk for recurrent peripheral embolic events and for future thromboembolic stroke. Lifelong anticoagulation is required. The literature concerning the incidence, risk, diagnosis, management and prognosis of peripheral arterial emboli in atrial fibrillation is reviewed.

Keywords: Arterial, Atrial fibrillation, Peripheral, Thromboembolism