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At least 235 records · Page 13Linked to original sources
PubMed2003

Ten-year experience in autogenous reconstruction with the femoral vein in the treatment of aortofemoral prosthetic infection.

OBJECTIVE: to study the short and long term effectiveness of in situ replacement of infected aortic grafts with the lower extremity deep veins. METHODS: forty-nine patients operated on for infrarenal aortic graft infection since 1990 were studied. Diagnosis of infection was based on clinical signs, bacteriological tests and typical findings on CT scan and leukocyte scan. The surgical treatment consisted in harvesting the femoral vein, total graft excision, thorough debridement and in situ reconstruction with the femoral veins. After discharge, the patients were followed at 6 monthly intervals with clinical examination, duplex and/or CT scan. RESULTS: there were four in-hospital deaths (8%). One patient required above-knee amputation (2%) and there were two graft limb occlusions (4%). With a mean follow-up 41 months, another 13 patients died, unrelated to the operation (29%). There were no late amputations and only two late graft limb stenoses (4%). We have a 5 year survival rate of 60%, a 5 year limb salvage rate of 98%, and a 5 year primary patency rate of 91%. There were no cases of aneurysmal dilatation of vein grafts and no incidence of reinfection. CONCLUSION: in situ reconstruction with the lower extremity deep veins is in the long term a safe and attractive alternative in the treatment of infrarenal aortic graft infection.

Aged↗
PubMed1980

Permanent pacemaker implantation using the femoral vein: a preliminary report.

A permanent pacemaker was implanted through the femoral vein in 23 patients using the percutaneous puncture technique. The pulse generator was placed in the lower abdominal wall. The method is simple and reduces the time necessary to accomplish implantation. Catheter extrusion in one patient was easily corrected. Another patient had late thrombophlebitis, possibly unrelated to the procedure. Catheter dislodgement occurred in four (4) patients and penetration of the right atrial appendage and right ventricular apex each occurred once. We believe these problems can be circumvented with more experience and expect the femoral approach to be a simple and practical method permanent pacemaker implantation.

Abdominal Muscles↗
PubMedDate not supplied

Doppler respiratory patterns in the femoral veins with pelvic vein obstruction.

An appropriate Doppler response to valsalva in the common femoral veins has been described previously as excluding a more proximal venous obstruction. We describe our experience in three patients in whom an appropriate response to valsalva did not exclude a more proximal pelvic venous obstruction. Dampening of the Doppler waveforms on the affected side when compared with the opposite limb led to the diagnosis of proximal venous obstruction.

Adult↗
PubMed1999

Cigarette smoke impairs endothelium-dependent relaxation in rabbit superficial femoral veins.

BACKGROUND: The use of autogenous vein for arterial reconstruction provides the optimal conduit for limb salvage. Cigarette smoking is a risk factor for vascular disease and may adversely affect graft patency and limb preservation rates of extremities reconstructed with autogenous vein. This study was performed in order to determine the effects of cigarette smoke on venous endothelium-dependent relaxation which is mediated by nitric oxide. MATERIALS AND METHODS: New Zealand white rabbits were exposed to cigarette smoke in a 240-ft3 air-flow chamber for 3 h per day, 5 days per week, for 8 weeks. A control group was treated similarly without infusion of smoke into the chamber. Elevated serum cotinine and carboxyhemoglobin levels comparable to those of chronic smokers were observed in the experimental group. After 8 weeks, the superficial femoral veins were explanted, cut into 3-mm segments, and studied in organ chambers. RESULTS: No difference in contractile response to KCl (80 mM) (control, 0.10 +/- 0.06; smoke, 0.17 +/- 0.04) or norepinephrine (EC50) (control, 0.78 +/- 0.18; smoke, 0.87 +/- 0.11) was seen. A significant decrease in relaxation was noted with all doses of acetylcholine (M) (control, 10(-8) - 50.35 +/- 8.37, 3 x 10(-8) - 71.20 +/- 9.05, 10(-7) - 88.32 +/- 13.72, 3 x 10(-7) - 92. 86 +/- 13.69; and smoke, 10(-8) - 8.25 +/- 1.83*, 3 x 10(-8) - 19.11 +/- 5.11*, 10(-7) - 31.84 +/- 7.90*, 3 x 10(-7) - 39.74 +/- 8.65*; *P < 0.05). Both control and smoke veins relaxed completely with sodium nitroprusside. CONCLUSIONS: Superficial femoral veins, when exposed to cigarette smoke, demonstrated a significant decrease in endothelium-dependent relaxation in response to acetylcholine without smooth muscle injury. This loss of vasomotor tone could be detrimental over time in veins which have been placed as arterial conduits.

Acetylcholine↗
PubMed1993

Cofactors of constitutive nitric oxide synthase and endothelium-dependent relaxations in canine femoral veins.

Enzymatic production of nitric oxide (NO) in arterial endothelial cells requires the cofactors calmodulin and nicotinamide adenine dinucleotide phosphate (NADPH). Experiments were designed in investigate whether these cofactors are required for endothelium-dependent relaxations in canine femoral veins. Veins were removed from anesthetized dogs and cut into rings. Endothelium was deliberately removed from some rings. All rings were incubated with indomethacin (1 x 10(-5) M). In separate sets of experiments, rings were incubated with calmidazolium (1 x 10(-5) M), fendiline (1 x 10(-6) M), both inhibitors of calmodulin or diphenylene-iodonium (1 x 10(-5) M; DPI) an inhibitor of NADPH. Concentration-response curves were obtained for acetylcholine (ACh), ADP, thrombin, A23187, and NO in rings contracted with a submaximal concentration of prostaglandin F2 alpha (PGF2 alpha) in the presence of the inhibitors and compared with a solvent control (dimethyl sulfoxide, DMSO). Relaxations to ACh, ADP, and thrombin were reduced by the inhibitors of both cofactors. Relaxations to A23187 were reduced by inhibitors of calmodulin but not NADPH; inhibitors of both NADPH and calmodulin caused no significant reduction in relaxations to NO. These data suggest that endothelium-dependent relaxations in canine femoral veins are mediated by factor(s) that are partly dependent on calmodulin or NADPH as cofactors for their production or release.

Amino Acid Oxidoreductases↗
PubMed1996

Femoral vein blood flow during transurethral resection of the prostate.

OBJECTIVE: To determine whether bladder distension affects venous haemodynamics during transurethral resection of the prostate (TURP) such that irrigating fluid is more easily absorbed. PATIENTS AND METHODS: The right common femoral vein was examined using an ultrasound Doppler blood-flow scanner in 10 patients (mean age 73 years, range 63-80) undergoing TURP. Measurements of blood flow were performed before, during and after the bladder was filled with irrigating solution. Fluid absorption was measured by the ethanol method. RESULTS: Measurements before, half-way through and immediately after the resection all showed that the luminal diameter and the cross-sectional area of the femoral vein increased significantly when the bladder was filled with irrigating fluid. Furthermore, a decrease in the normal variation of blood flow with breathing often occurred when the bladder was filled, indicating that proximal venous obstruction was the cause of the increase in vessel diameter. However, there was no apparent association between these changes and the absorption of irrigating fluid. CONCLUSIONS: Filling the bladder with irrigating fluid with the patient in the lithotomy position during TURP was followed by signs of iliac venous obstruction but this did not correlate with the absorption of irrigating fluid.

Aged↗
PubMed1991

Reconstruction of rat femoral veins with microvascular prostheses.

Synthetic conduits have not been suitable for microvascular reconstruction owing primarily to their high thrombogenicity. Vein replacements are the most vulnerable to thrombosis because of their low shear rates and low pressure. Experimental replacement of microvenous segments with prosthetic segments has shown little success. Recent technological advances in biomaterials and control of thrombogenesis provide the potential for success in the development of venous prostheses. The purpose of this study was to assess the use of nonbiodegradable composite polyurethane microvascular prostheses for reconstruction of rat femoral veins. Rat femoral venous defects of 10 mm were reconstructed with autogenous vein (n = 12), unprocessed plain polyurethane (n = 5), and nonbiodegradable composite polyurethane (n = 31). Patency was evaluated by direct observation and proximal venous milking tests. The patency rate of composite grafts was not significantly different from that of isotopic vein (p = 0.5, Fisher's exact test), and both had higher patency than unprocessed polyurethane (p less than 0.01). Composite grafts were examined sequentially using light and scanning electron microscopy. Grafts were fully endothelialized between the first and third months. The neointimal, neomedial, and neoadventitial layers could be seen more distinctly over time. New opportunities in reconstructive microsurgery may be opened by microvascular prostheses that are complaint and thromboresistant.

Animals↗
PubMed1991

The changes in intramuscular pressure and femoral vein flow with continuous passive motion, pneumatic compressive stockings, and leg manipulations.

Intramuscular pressure was measured continuously in the deep compartment of the calf and anterior thigh of volunteers while their legs were cyclically moved from 0 degrees to 90 degrees back to 0 degrees (angle of knee flexion) in an anatomic continuous passive motion (CPM) device and a nonanatomic CPM device. Femoral venous flow was measured continuously using a thermodilution technique in volunteers while their legs were moved in both CPM devices, during inflation of a pneumatic stocking, and during several leg manipulations. Baseline intramuscular pressures in the deep calf and anterior thigh were 10.0 +/- 1.9 mmHg and 4.9 +/- 1.9 mmHg, respectively (mean +/- standard error). Both the anatomic and nonanatomic CPM devices produced a statistically significant maximal increase in pressure in the calf. By contrast, only a decrease in pressure occurred in the thigh with both devices. Baseline femoral vein flow measured by the thermodilution technique was 311 +/- 38 ml per minute. Significant increases in femoral vein flow were seen with both CPM devices. The maximal flow produced by the anatomic CPM was 1199 ml per minute and was approximately four times higher than baseline flow and approximately 1.4 times the maximal flow change seen with the nonanatomic CPM (836 ml per minute). The greatest net increase in flow was observed between 60 degrees and 90 degrees of knee flexion with both devices. Overall, passive straight-leg elevation produced the largest flow (1524 ml per minute), followed by the anatomic CPM and nonanatomic CPM, and then by active ankle dorsiflexion(640 ml per minute), pneumatic stocking inflation (586 ml per minute), manual calf compression (532 ml per minute), and passive dorsiflexion (385 ml per minute)(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2005

Extension of saphenous thrombus into the femoral vein: a potential complication of new endovenous ablation techniques.

Endovenous techniques such as radiofrequency ablation (RFA) and endovenous laser therapy (ELT) have emerged as percutaneous minimally invasive procedures for ablation of incompetent great saphenous veins in patients with varicosity and venous insufficiency. Early reports showed safety and efficacy of both techniques, with excellent technical success rates and few major complications, such as deep vein thrombosis or pulmonary embolism. During our initial experience with ELT in 56 limbs of 41 patients, 39 underwent postoperative duplex scanning. We encountered three cases (7.7%) with thrombus extension into the common femoral vein. All three patients were anticoagulated, and a temporary inferior vena cava filter was placed in one. All remained asymptomatic. The thrombus resolved by 1 month in all three patients. Review of the literature revealed that the incidence of thrombus extension into the common femoral vein or deep vein thrombosis in published clinical series is 0.3% after ELT and 2.1% after RFA. This possibility warrants routine postoperative duplex scanning, more alertness during these procedures, and patient education on this possible complication.

Aged↗
PubMed1985

Muscle and femoral vein temperatures during short-term maximal exercise in heart failure.

Core temperature decreases throughout short-term maximal exercise in heart-failure patients. To investigate possible causes for this unusual response to exercise, we studied core (pulmonary arterial blood), femoral vein, muscle, and skin temperatures in eight patients with severe heart failure who performed maximal upright incremental bicycle exercise to 50 W. A normal group (n = 4) was exercised for comparison. In the heart-failure patients, core temperature was 36.95 +/- 0.37 degrees C at rest, significantly (P less than 0.05) decreased at 25 W of exercise to 36.59 +/- 0.40 degrees C, and at 50 W remained decreased to 36.57 +/- 0.40 degrees C. In comparison, we found that the resting core temperature in the normal subjects was 37.28 +/- 0.34 degrees C, was the same at 25 W (37.29 +/- 0.41 degrees C), and increased significantly (P less than 0.05) to 37.50 +/- 0.32 degrees C at 50 W of exercise. Femoral vein temperature in heart-failure patients (n = 6) was below core temperature throughout exercise to 25 and 50 W (36.22 +/- 0.62 and 36.34 +/- 0.65 degrees C, respectively). Muscle temperature (n = 7) was significantly (P less than 0.05) lower in the heart-failure patients (34.8 +/- 1.1 degrees C) at rest compared with the normal subjects (36.2 +/- 1.0 degrees C). During exercise, muscle temperature increased above core temperature in only four of the heart-failure patients and was significantly (P less than 0.05) lower (36.5 +/- 1.3 degrees C) compared with the normal subjects (38.0 +/- 0.2 degrees C).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1995

Modified crush-avulsion anastomosis model on the rat femoral vein.

A crush-avulsion anastomosis model was established on the rat femoral vein. Saline or heparin was used as a luminal topical agent and was allowed to contact the damaged endothelium for 10 min. Patency and coagulation parameters were investigated for 1 week. The heparin treated group had a patency rate of 93% at 1 hr vs. 13% for the saline treated group (P < 0.001). At 7 days, the heparin treated group had an 87% patency vs. 7% for the saline-treated group (P < 0.001). Scanning electron micrography (SEM) provided evidence of the deposition of the components of early thrombosis in the crushed venous wall. In contrast, the SEM of the heparin treated group shows a paucity of any evidence of thrombus. These results indicate that the rat vein crush-avulsion model is a reliable and reproducible thrombosis model with low patency. The methods used with the topical agent may improve the patency rate in crush avulsion injuries.

Anastomosis, Surgical↗
PubMed1993

The superficial femoral vein as autogenous conduit in the treatment of prosthetic arterial infection.

Autogenous reconstruction is a well-accepted alternative treatment for prosthetic infection after reconstructive arterial surgery. Because of its technical complexity and the lack of suitable substitutes, the procedure remains limited to a few selected centers. We describe four patients with prosthetic infection after reconstructive surgery for lower limb ischemia. Treatment consisted of prosthetic excision and aortofemoral grafting with the use of the superficial femoral vein. All patients survived the operation and infection was eradicated in all cases. We conclude that the superficial femoral vein represents an acceptable arterial conduit in the treatment of these difficult cases.

Aged↗
PubMed1993

Experimental femoral vein reconstruction with expanded polytetrafluoroethylene grafts seeded with endothelial cells.

The effect of endothelial cell seeding on the patency of small-caliber expanded polytetrafluoroethylene (ePTFE) grafts used for venous replacements in a canine experimental model was evaluated. Grafts were implanted bilaterally in 12 dogs as femoral vein interpositions. In each animal, one graft was seeded with enzymatically derived homologous endothelial cells which had been cultivated for 3 days in vitro before implantation, whereas the contralateral graft was not seeded. In five dogs, venography was performed at 2 weeks, and grafts were then excised. In the remaining seven dogs, venography was performed at both 2 and 4 weeks, with graft excision at 4 weeks. Graft patency at 2 weeks for seeded grafts was 75% (nine of 12) compared with only 33% (four of 12) for unseeded grafts (P < 0.02). There were no new episodes of thrombotic occlusion between 2 and 4 weeks. Five dogs with thrombus in the control graft did not develop thrombus in the contralateral seeded graft. Furthermore, each dog with a patent control graft had no thrombus in the seeded graft. It is concluded that the early patency of seeded ePTFE grafts is superior to that of unseeded ePTFE grafts in the femoral vein.

Animals↗
PubMed1974

Investigations on the mode of action of ergotamine in the isolated femoral vein of the dog.

1 Experiments on spiral strips cut from the femoral vein of dogs suspended in Krebs-Henseleit solution were carried out.2 Ergotamine caused stimulation in concentrations about 350 times lower than noradrenaline (ED(50) of ergotamine = 2.2 x 10(-9) M; ED(50) of noradrenaline = 7.6 x 10(-7) M), but the maximal responses to ergotamine were only about one third those to noradrenaline.3 The pA(2) value of ergotamine against noradrenaline was 8.8.4 The effects of ergotamine can be blocked by prior administration of phentolamine. The pA(2) value for phentolamine against ergotamine was 6.8 and the pA(2) value for phentolamine against noradrenaline was 7.5.5 It is concluded that the stimulant action of ergotamine on smooth vascular muscle probably is mediated mainly via alpha-adrenoceptors.

Adrenergic alpha-Antagonists↗
PubMed2000

Duplicated popliteal and superficial femoral veins: incidence and potential significance.

BACKGROUND: Duplication of the popliteal and superficial femoral veins (PV, SFV) is a normal variant previously reported in up to 25% of limbs. Little clinical significance, however, has been attributed to this apparently common anomaly. The present study was designed to determine the incidence of duplications in individuals presenting for venous incompetence studies, and whether their presence could, in theory, act as a predisposing factor to deep venous thrombosis (DVT) formation. METHODS: Duplex ultrasound examinations were performed in which venous duplications were actively searched for and recorded. The diameters of both limbs of any duplicated system and the single vessel immediately distal to it were recorded. Using these measurements, the changes in total cross-sectional area (CSA) associated with these anomalies were calculated. In addition, with the knowledge that the volume flow rate must remain constant, the velocity changes associated with such systems were calculated. RESULTS: A total of 248 limbs from 177 patients was scanned. Duplications were found in 39 (15.7%) of these limbs. Of these, 30 limbs (77%) involved only the SFV, seven (18%) involved both the SFV and PV, and two (5%) involved only the PV. Short-segment SFV duplications were used to calculate the percentage change in total CSA and therefore blood flow velocities. Of the 13 (33%) suitable for such calculations, and calculating for each individual duplicated system, a mean increase in the vessel's total CSA of 42%, which corresponded to a theoretical decrease in blood flow velocity of 36%, was found. CONCLUSION: The present study confirms the significantly high incidence of duplications of the PV and SFV and raises the possibility of the potential for DVT formation secondary to changes in flow velocities.

Adolescent↗
PubMed2001

Microsurgical repair after crush-avulsion injury of the femoral vein in rats: prevention of microvascular thrombosis with recombinant human tissue-type plasminogen activator (rt-PA).

Vein thrombosis is often encountered in microsurgery, especially in the case of crush-avulsion injuries. The aim of this study was to investigate the effect of systemic administration of recombinant tissue-type plasminogen activator (rt-PA) on the patency of the femoral vein of the rat, which had previously sustained a crush-avulsion injury. The study consisted of 3 groups of male Wistar rats, 20 animals each. A standardized crush-avulsion injury model was used. After microvascular repair of the femoral vein, the animals received either normal saline (group A), heparin 100 U/kg body weight (group B), or rt-PA 3.5 mg/kg body weight (group C) systemically. Patency tests were performed at 20 minutes, 48 hours, and 1 week after blood flow reestablishment. According to our results, the patency rate of the rt-PA group was significantly higher than in both the control and heparin groups.

Animals↗
PubMed2007

[Thrombosis of the inferior vena cava and the iliac and femoral veins in a 24-year old man].

HISTORY AND ADMISSION FINDINGS: A 24-year-old patient presented with nonspecific epigastric pain, general feebleness and weakness of both legs. The cardiopulmonary investigations were unremarkable. The abdomen was soft, without muscular resistance or local pressure tenderness. Both legs were moderately swollen without other findings. INVESTIGATIONS: The laboratory tests showed an elevated D-dimer and fibrinogen, as well as a heterozygous factor V Leiden mutation. Both duplex ultrasonography and computed tomography revealed thrombosis of the distal inferior vena cava (IVC) and both iliac and femoral veins. A short segment of the IVC between the left renal and intrahepatic veins was a-genetic. DIAGNOSIS, TREATMENT AND COURSE: Anticoagulation treatment with phenprocoumon was started for the deep vein thrombosis. At the one-year follow-up no thrombosis of the vena cava and the iliac and femoral veins was detected. CONCLUSION: Thrombosis of the IVC in combination with a pelvic vein thrombosis is a rare condition in young patients. If this venous abnormality is found, thrombophilia should be considered in the differential diagnosis. Anticoagulation is the treatment of choice.

Adult↗