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PubMed1975

[Unilateral agenesis of the common femoral vein in a young boy with Klippel-Trénaunay syndrome (author's transl)].

A boy aged 4 years and 3 months with Klippel-Trénaunay syndrome showed a vein the thickness of a finger running suprapubicly. When he was standing it was filled tightly. Angiography showed agenesis of the right common femoral vein. Reflux from the right leg passed through this vein to the left common femoral vein. On the basis of the literature the place of these vascular dysplasias in the Klippel-Trénaunay syndrome is discussed. Diagnosis and treatment of such venous malformations are mentioned.

Angiomatosis↗
PubMed1994

[Use of autologous femoral vein in superior vena cava thrombosis. Case report and review of the literature].

We report on a 52-year old male patient who underwent implantation of an insulin pump because he had diabetes and in whom superior vena cava syndrome developed as a long-term complication. After unsuccessful lysis therapy superficial femoral vein was implanted to form a bypass from the internal jugular vein to the right atrium. The postoperative course was uneventful from the aspects of both the bypass and the leg after explantation of the superficial femoral vein. The bypass is still patent 7 months after the operation, and the patient has no symptoms. Autogenous superficial femoral vein can be used successfully in the reconstruction of large venous vessels. It should be the graft of choice for young patients with benign diseases. We compare our result and those obtained with different substitutes described in the literature that have been used for reconstruction in superior vena cava syndrome.

Femoral Vein↗
PubMedDate not supplied

Leiomyosarcoma of the femoral vein in a marathon runner.

Leiomyosarcoma of the femoral vein is a rare tumor. Physicians involved in the care of athletic patients must not be cavalier in evaluating overuse injuries and should endeavor to make a specific diagnosis. If atypical findings, such as generalized extremity swelling, are present, the physician must consider systemic illness including malignancy in apparently healthy, physically active individuals.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2004

Totally implantable femoral vein catheters in cancer patients.

INTRODUCTION: Totally implantable devices are increasingly being utilized for chemotherapy treatment of oncological patients. When it is impossible to implant the reservoir on the anterior wall of the thorax, or when there is an obstruction of the superior vena cava system, alternative access routes must be sought. Of these, the femoral vein is the most utilized. Few studies have been performed to analyse the results obtained from the implantation and utilization of such catheters in the femoral vein. The goal of this work was to prospectively study the results obtained from the implantation of 20 TIC in femoral veins in a large-sized cancer hospital with its own dedicated vascular clinical team. MATERIAL AND METHODS: Twenty femoral TIC were inserted in 20 patients out of a group of 560 cancer patients submitted to TIC implantation for chemotherapy. Evaluations were made of the early and late-stage complications and patient evolution until removal of the device, death or the end of the treatment. RESULTS: The prospective analysis showed a mean duration of 215 days for the catheters. There were 16 patients with no complications. There were no early complications. Among the late complications, three were infections, representing 0.69/1000 days of catheter use, and one was a deep vein thrombosis (0.23/1000 days of catheter use). One catheter was removed due to primary bacteremia and one due to subcutaneous pocket infection. Fourteen patients died while the catheter was functioning and four patients are still making use of the catheter. CONCLUSION: The low rate of complications implying catheter loss in this study confirms the safety and convenience of the use of femoral TIC in patients who cannot be submitted to implantation in the superior vena cava system.

Adult↗
PubMed1971

Passive flexion and femoral vein flow: a study using a motorized foot mover.

The effect of rhythmic passive flexion of the foot on femoral vein blood volume flow rate has been investigated in 11 patients undergoing surgery for varicose veins. With rates of flexion varying from 24 to 50 per minute and with amplitudes varying from 20 degrees to 50 degrees it has been shown that the peak femoral vein flow can be increased to twice its normal value and that its pulsatility can be increased elevenfold. These increases are proportional to both the rate and the amplitude of the flexion, the maximum occurring, theoretically, when the foot is flexed +/-28 degrees about a line perpendicular to the leg.The investigation has further shown that the effects of sustained passive flexion are maintained, without appreciable dimunition, for 30 minutes and that the maximum increases are produced in those patients who have the lowest resting flows. It is suggested that per-operative passive flexion of the feet may be a good prophylactic against postoperative deep vein thrombosis.

Blood Flow Velocity↗
PubMed1970

Effect of externally applied pressure on femoral vein blood flow.

The effect of incremental increases in external pressure, applied to the leg, on blood volume flow in the femoral vein was studied in dogs. Clinical investigation of external pressure increases was also carried out on nine patients undergoing surgery for varicose veins. An external pressure between 5 and 15 mm. Hg caused a sustained increase in mean femoral vein flow both in a control and in the compressed limb. Above 15 mm. Hg external pressure flow decreased in the compressed limb but was maintained at an increased level in the control limb.If external compression is to be used to prevent and treat deep vein thrombosis its application must be carefully controlled.

Animals↗
PubMed1997

Ultrasound-guided cannulation of the femoral vein for acute haemodialysis access.

BACKGROUND: Central venous access is a mandatory part of patient management in many clinical settings and is usually achieved with a blind, external landmark-guided technique. The purpose of this study is to evaluate whether an ultrasound technique can improve on the external landmark method. METHODS: We prospectively evaluated an ultrasound-guided method in 28 patients undergoing femoral vein cannulation for acute haemodialysis access and compared the results with 38 patients in whom an external landmark-guided technique was used. External landmark-guided technique was done by manual localization of the femoral artery in the femoral triangle inferior to the inguinal ligament with needle insertion medial to the artery. Ultrasound-guided cannulation was performed in the same location with the aid of an ultrasound device (Site-Rite, Dymax Corp., USA) with a 7.5 MHz transducer covered by a sterile sheath. RESULTS: Cannulation of the femoral vein was achieved in all patients (100%) using ultrasound and in 34 patients (89.5%) using the landmark-guided technique. The vein was entered on the first attempt in 92.9% of patients using ultrasound and in 55.3% using the landmark technique (P < 0.05). Average access time (skin to vein) was similar but total procedure time was 45.1 +/- 18.8 s by the ultrasound approach and 79.4 +/- 61.7 s by the landmark approach (P < 0.05). Using ultrasound, puncture of the femoral artery occurred in 7.1% of patients, and haematoma in 0%. Using external landmark technique, puncture of the femoral artery occurred in 15.8% of patients, and haematoma in 2.6%. CONCLUSIONS: Ultrasound-guided cannulation of the femoral vein reduces the time required for the procedure, reduces the number of passes needed to puncture the vein, and minimizes complications such as arterial puncture or haematoma.

Acute Kidney Injury↗
PubMed1984

[3H]dihydroergocryptine binding to alpha-adrenoceptors in human femoral veins and arteries.

In order to characterise subtypes of alpha-adrenoceptors in human vascular tissue, radioligand binding studies with [3H]dihydroergocryptine were carried out in human femoral veins and arteries. Binding of [3H]dihydroergocryptine to venous and arterial membranes was rapid and reversible reaching steady state within 4-6 min at 25 degrees C. [3H]Dihydroergocryptine was displaced from its receptor site on vascular membranes by unlabelled alpha-adrenoceptor agonists and antagonists in a concentration-dependent manner. Yohimbine and guanfacine which possess high affinity for alpha 2-adrenoceptors were more effective in competing for [3H]dihydroergocryptine binding sites in veins than in arteries. Prazosin and phenylephrine with high affinity for alpha 1-adrenoceptors were more effective displacers in arteries than in veins. The results suggest that the alpha-adrenoceptor population differs between human femoral veins and arteries. In veins, predominantly alpha 2-adrenoceptors are present, whereas in arteries the adrenoceptor of the alpha 1 type prevails. The results show that the uneven distribution of alpha 1- and alpha 2-adrenoceptors as has been found in animal experiments and pharmacological investigations with human vessels could also be demonstrated by binding studies with [3H]dihydroergocryptine in human femoral arteries and veins.

Adrenergic alpha-Agonists↗
PubMed2002

[Operation of cross-section and extravasal correction of the femoral vein valves in varicose disease using minimal access].

Taking into account the heightened demands of patients for the quality of life the aesthetics of upper incisions in varicose disease gains significance. The authors adduce the depiction of the procedure and results of application of two original operations: cross-sectomy with application of public approach and extravasal correction of femoral vein valves using proper fascial tunics by inguinal mini-access. Endosurgical manipulations are performed inside operative space, created by hook-elevator with endoillumination, permitting to reduce cutaneous incision and remove it to aesthetically less significant zones. The 2 cm long incision in the hair-bearing part of public region in inside and horizontal direction was applied in cross-sectomy. The transverse cutaneous incision 2-2.5 cm long 6-7 cm down inguinal ligamentum and medially about femoral vessels projection was proposed for valvuloplasty. Cross-sectomy using mini-access was done in 49 patients, valvuloplasty of femoral vein--in 41. Estimation of immediate and late follow-up results witnesses, that elaborated endosurgical procedures of cross-sectomy and valvuloplasty of femoral vein in patients with varicose disease using mini-access corresponds to aesthetical demands of modern phlebology.

Adolescent↗
PubMed1995

Femoral vein stasis during laparoscopic cholecystectomy: effects of graded elastic compression leg bandages in preventing thrombus formation.

Venous stasis of the legs during laparoscopic cholecystectomy was compared between patients without graded compression leg bandages (Group 1; n = 12) and patients with such bandages (Group 2; n = 12) by measuring mean blood flow velocity and cross-sectional area of the femoral vein using a color Doppler ultrasonography. In Group 1, when velocity and area were measured in the supine position, a significant decrease in velocity (p < .05) and a significant increase in area (p < .05) occurred after abdominal insufflation to 10 mm Hg. These changes were greater during abdominal insufflation in the reverse Trendelenburg position than during abdominal insufflation in the supine position. In Group 2, flow velocity was significantly higher (p < .05) before abdominal insufflation as compared with Group 1. After abdominal insufflation to 10 mm Hg and a postural change, velocity significantly decreased (p < .05) and area significantly increased (p < .05) in Group 2, similar to the results in Group 1. During abdominal insufflation at 5 mm Hg or lower, the use of the graded compression bandage was found to be useful for preventing femoral vein stasis. During abdominal insufflation at 10 mm Hg or in the reverse Trendelenburg position, the bandage did not prevent femoral vein stasis.

Bandages↗
PubMed2004

Oxytocin content in the venous blood outflowing from the vicinity of the cavernous sinus and from the femoral vein.

OBJECTIVE: Magnocellular neuroendocrine cells of the supraoptic nucleus of the hypothalamus produce and release the hormones vasopressin and oxytocin in response to a variety of stimuli to regulate body water and salt as well as and parturition and lactation. The aim of the present study was to estimate oxytocin release into the blood dialysate outflowing from the vicinity of the cavernous sinus and from the femoral vein after NMDA (N-methyl-D-aspartic acid) infusion or acute hypoxia. METHODS: The samples of dialysates of venous blood outflowing from the vicinity of the cavernous sinus and, for comparison, from the femoral vein were collected in anesthetized rats. Oxytocin was determined in the sample of dialysates by radioimmunoassay. RESULTS: NMDA acid infusion or acute hypoxia caused an increase of oxytocin concentration in the blood dialysate outflowing from the vicinity of the cavernous sinus of the sella turcica and from the femoral vein. A blockade of the NMDA receptors by specific and non-specific antagonists significantly inhibited the increase in the blood dialysate oxytocin concentration. CONCLUSION: The results indicate the involvement of excitatory amino acid or acute hypoxia in the control of oxytocin release into the blood.

Animals↗
PubMed1991

[Valvuloplasty and fixation of the femoral vein for valvular incompetence of deep veins of the lower extremity].

Fifty cases (54 limbs) of valvuloplasty and fixation of the incompetent valve of the femoral vein were reported. Diagnosis was made by clinical features, measurement of ambulatory venous pressure, ascending and descending phlebography, and by intraoperative checking the blood flow. After repairing the highest primary valve of the superficial femoral vein a circular suture around the vein at 2 mm under the repaired valve was made to prevent the recurrence of valvular incompetence. Patients were followed-up for 6 to 45 months (mean 20.2 months) with satisfactory results in all and excellent in 50 limbs (92.6%). The swelling subsided, stasis dermatitis and ulcer healed promptly, the "heavy leg" became light, and venous pressure of post-exercise lowered significantly (P less than 0.01). No retrograde flow of contrast medium was detected during the descending phlebography after operation. The results suggest that this operation is better than simple repair of the incompetent valve.

Adult↗
PubMed2003

The reproducibility of the ratio of volume flow in the common femoral vein and artery for quantification of the severity of venous insufficiency.

BACKGROUND: The ratio of volume flow in the common femoral vein and artery denoted as venous-arterial Flowindex (VAFI) is significantly increased in venous insufficiency according the clinical grade of the disease. This study was done to investigate the reliability and reproducibility of VAFI as quantitative pattern. PATIENTS AND METHODS: In 43 patients with varicose veins C4-6 EPAS,D,PPR (PVV), 40 with postthrombotic syndrome C4-6 ESAS,D,PPR,O (PTS) and 48 healthy volunteers volume flow in the common femoral vein (VFV) and artery (VFA) were measured by duplex. Division of VFV by VFA calculated VAFI. VAFI-measurement was repeated 5 times at an interval of ten minutes in 63 subjects (23 PVV, 20 PTS, 20 healthy) and it was performed at three different days in 68 subjects (20 PVV, 20 PTS, 28 healthy). RESULTS: Mean VAFI +/- standard deviation was 1.39 +/- 0.26 in PVV, 1.42 +/- 0.26 in PTS and 0.93 +/- 0.13 in healthy veins (p < 0.001). VAFI remained stable and significantly increased (p < 0.001) in PVV and PTS compared to healthy veins during 40 minutes and also within three different days. CONCLUSION: The venous-arterial flowindex VAFI is a reproducible pattern of the hemodynamic severity in venous insufficiency.

Blood Flow Velocity↗
PubMedDate not supplied

Incidence of femoral vein occlusion after catheter ablation in children: evaluation with magnetic resonance angiography.

Catheter ablation in children requires placement of multiple large femoral venous sheaths and catheters. Magnetic resonance angiography (MRA) was used to evaluate the effect of indwelling lines on femoral venous blood flow. Between October 1993 and February 1994 a total of 17 patients scheduled for catheter ablation underwent venous MRA. Two-dimensional time-of-flight MRA was performed 12-70 hours after catheterization on all patients. All patients received intravenous heparin during the procedure and had aspirin therapy instituted after ablation. Eighteen catheter ablations and MRA studies were performed on the 17 patients (one patient underwent repeat ablation). There were 7 females and 10 males, with a mean age of 14.8 +/- 4.2 years (range 8-21 years). Patients had three venous sheaths inserted in the left femoral vein (5F, 6F, and 7F with external diameters measuring 1.7, 2.0, and 2.3 mm, respectively) and one sheath in the right femoral vein (7F). Four patients (22%) had altered venous flow (two complete obstructions and two partial obstructions) following catheterization. None of these patients experienced symptoms or complications. It was concluded that there is an increased incidence (22%) of venous obstruction following catheter ablation, but there are no related complications. Venous MRA provides a rapid, noninvasive method for evaluating venous flow abnormalities and possibly detects patients at risk for complications.

Adolescent↗
PubMed2002

The use of cryopreserved femoral vein grafts for hemodialysis access in patients at high risk for infection: a word of caution.

BACKGROUND: Several studies have reported success in the use of venous homografts for arteriovenous access and for arterial bypass in infected fields. On the basis of these reports and in an effort to prevent the loss of vascular access to infection, we performed arteriovenous graft placement with cryopreserved femoral vein in patients at high risk for graft infection. This study reviews the results of our experience. METHODS: Of approximately 3100 dialysis access operations performed in a single vascular surgery service between October 1999 and July 2001, 20 patients received arteriovenous access grafts with cryopreserved femoral vein. All patients were judged to be at high risk for infection of the access on the basis of the presence of active infection at the time of graft implantation, the location of the graft in the thigh position, or a history of multiple access infections. The grafts were placed in three locations: thigh (n = 14), upper extremity (n = 3), and chest wall (n = 3). RESULTS: No early operative deaths or graft thromboses were seen. There were three late deaths: two from cardiac disease and one from a graft-related complication. Thirteen major graft related complications (65%) occurred in the 20 patients. There were three generalized graft infections (15%) and eight localized graft infections (40%) at dialysis needle access sites in 11 patients. Six of the graft infections were associated with graft rupture and frank hemorrhage, resulting in one patient death from exsanguination. Two grafts (10%) thrombosed, one of which was salvaged after thrombectomy and revision. These complications occurred between 1 and 14 months after implantation. At a mean follow-up period of 13 months (range, 1 to 17 months), only five of the 20 patients (25%) have a functioning cryopreserved femoral vein arteriovenous graft. CONCLUSION: The use of cryopreserved vein graft for hemodialysis access in patients at high risk for infection is associated with a high incidence rate of graft infection and rupture, particularly when placed in the thigh position. The routine use of cryopreserved vein graft in the thigh should be avoided. The in situ replacement of infected polytetrafluoroethylene arteriovenous grafts with cryopreserved vein should be considered if alternative sites for new access placement are unavailable.

Catheters, Indwelling↗
PubMed2000

Use of superficial femoral vein for hemodialysis arteriovenous access.

Maintaining hemodialysis access in the expanding number of patients with end-stage renal disease is a difficult and challenging problem. Published guidelines outline the initial recommendations for hemodialysis access; however, there is little consensus about the most appropriate options for the subset of patients with repeated access failures and/or unsuitable veins. Two case reports are presented describing the use of composite saphenous-superficial femoral vein autogenous accesses placed in the upper and lower extremities. The function of the autogenous accesses appeared to be similar to a mature arteriovenous fistula in the short-term, although further longitudinal studies are required. The superficial femoral vein may be a useful hemodialysis access conduit for patients with limited access options.

Adult↗
PubMed1987

Effect of intravenous and intraperivenous injections of sclerosants (sodium tetradecyl sulfate and hydroxy polyethoxy dodecan) on the rat femoral vein.

The sclerosant effect of injected tetradecyl sulfate of sodium (STS) and hydroxy polyethoxy dodecan (HPD) was studied in the rat femoral vein. Intravenous (i.v.) and intravenous plus perivenous (i.v. + p.v.) injections of both sclerosants and physiologic saline were compared as to vein lumen occlusion, fibrosis, phlogosis, and damage to the artery and surrounding nervous and muscular tissues. The study was carried out in 30 rats treated by STS, in 30 treated by HPD, and 15 animals were injected with saline. The neurovascular bundle and adjacent muscle were removed at 48 h, 7 and 30 days and examined histologically. I.v. injections of STS produced a solid occlusion of the vein in a significant number of cases, after 30 days (P less than 0.01). A statistically significant number of solid occlusions of the femoral vein resulted after i.v. + p.v. injection of STS and HPD, at 48 h, 7 and 30 days (P less than 0.05; P less than 0.01). There was no significant difference between STS and HPD after i.v. + p.v. injection. After i.v. + p.v. we recorded a marked inflammation of muscle with signs of focal necrosis, at 48 h and 7 days. Our study indicated that i.v. + p.v. injection of STS and HPD provided a high degree of efficacy as regards vein occlusion. On the other hand, i.v. + p.v. injection induced a severe inflammation and necrosis of the tissues surrounding the sclerosed vein. Extrapolating our results to the endoscopic sclerotherapy for esophageal variceal bleeding, we conclude that paravariceal injection of sclerosants is a dangerous procedure, even though efficacious to reduce variceal hemorrhage, owing to the high risk of iatrogenic ulcers and esophageal perforation caused by muscular and mucosal necrosis.

Animals↗