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Arterial Missile Embolus Resulting from a Novel MechanismA Case Report
MAJ Jason A. Grassbaugh, MD1; COL Edward D. Arrington, MD1; COL Ronald J. Place, MD2; Brian D. Peyton, MD3; COL Robert M. Rush, MD1
1 Madigan Army Medical Center, 9040A Fitzsimmons Avenue, Fort Lewis, WA 98431. E-mail address for J.A. Grassbaugh: Jason.Grassbaugh@us.army.mil
2 Winn Army Community Hospital, 1061 Harmon Avenue, Fort Stewart, GA 31314-5641
3 Section of Vascular Surgery, University of Colorado Denver, 12631 East 17th Avenue, #L15-5416, Aurora, CO 80045
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Investigation performed at the Seeb Air Base Hospital, Seeb, Oman, and Madigan Army Medical Center, Fort Lewis, Washington



Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. None of the authors, or their institution(s), have had any financial relationship, in the thirty-six months prior to submission of this work, with any entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. Also, no author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2013 by The Journal of Bone and Joint Surgery, Inc.
JBJS Case Connector, 2013 Apr 24;3(2):e37 1-7. doi: 10.2106/JBJS.CC.L.00270
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Extract

Missile emboli from bullets occur infrequently, with the first reported case appearing in 18341. At least 160 reports of this phenomenon exist in the literature2. A variety of missile emboli, including arterioarterial as well as aortoarterial emboli, have been reported, with up to two-thirds causing peripheral ischemia3. The patient discussed in this case report initially had no symptoms in the affected right extremity. This may be common; less than one-third of missile emboli initially are symptomatic3. The patient was informed that data concerning the case would be submitted for publication, and he provided consent.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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