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At least 343 records · Page 19Linked to original sources
PubMed1993

Intravasal use of pliable K(+)-selective electrodes in the femoral vein of humans during exercise.

Continuous recording of plasma K+ concentration ([K+]) during exercise would be valuable in determining K+ fluxes associated with muscle activation. Pliable polyvinyl chloride electrodes were constructed by incorporation of valinomycin into a polyvinyl chloride membrane attached to the end of a catheter with a 1 mm outer diameter. Through an outer catheter the electrode was inserted into the femoral vein of human subjects. The setup allowed easy in vivo calibration, and rapid changes of femoral venous [K+] of < 0.1 mmol/l could easily be detected. Drift over 1 h amounted to < 3 mV and was corrected for by analysis of blood samples. Rapid changes in femoral venous [K+] occurred during and after dynamic exercise, short and prolonged isometric contractions, and repetitive isometric contractions of the quadriceps muscle. Combined with arterial blood sampling and flow measurements, the electrodes will allow good approximation of 1) cellular K+ efflux rate associated with increased electrical activity, 2) rate of intramuscular reuptake of K+ mediated by the Na(+)-K+ pump, and 3) rate of K+ loss to or uptake from the circulation by the muscle.

Exercise↗
PubMed2001

Autogenous reconstruction of infected arterial prosthetic grafts utilizing the superficial femoral vein.

BACKGROUND: Prosthetic infection after reconstructive vascular surgery is a most serious complication, associated with high mortality and amputation rates. Following excision of the infected graft, several methods of reconstruction are available. We present here our experience with autogenous reconstruction of infected prosthetic arterial grafts using the superficial femoral vein (SFV). METHODS: From November 1995 to December 1999, we used the SFV in seven patients (mean age 70 years) for reconstruction of an infected aortobifemoral (n = 2), aortoiliac (n = 1), femorofemoral bypass (n = 1), femorotibial (n = 2) and carotid crossover bypass (n = 1). Treatment encompassed complete prosthetic excision and autogenous reconstruction with the SFV alone or as a spliced graft with the greater saphenous vein (GSV) or basilic vein. RESULTS: There were no perioperative deaths or amputations. Two patients exhibited transient moderate swelling of the donor limb. In the follow-up, six patients are alive and well without any signs of recurrent infection. One patient died with an unrelated cause 24 months postoperatively. All donor limbs were asymptomatic for venous congestion in the long-term follow-up. CONCLUSION: The SFV provides a reliable tool for autogenous reconstruction after resection of infected prosthetic arterial grafts. Harvesting the SFV is well tolerated as long as the deep femoral and the popliteal vein are preserved.

Aged↗
PubMed2006

Cystic adventitial disease of the femoral vein presenting as deep vein thrombosis: a case report and review of the literature.

Cystic adventitial disease of veins is a rare condition. We report the case of a 28-year-old man who presented with a swollen leg secondary to obstruction of the common femoral vein as a result of this disease. He underwent excision of the cyst and made a full recovery. The presentation, investigation, treatment and pathology of this condition is discussed.

Adult↗
PubMed1989

Prosthetic microvenous grafting into the femoral vein of the rat; considerations concerning the anastomotic technique.

The sequential thrombotic events which occur after implantation of microvenous prostheses prepared from a polyurethane-based material (I.D. 1 mm, length 5 mm, n = 36) into the rat femoral vein by means of the conventional end-to-end suture technique were evaluated by direct inspection and by scanning electron microscopy during the first 24 postoperative hours. Thrombus formation started at the anastomotic sites on the exposed collagenous vessel wall tissue and increased with increasing postoperative time intervals, leading to complete occlusion of the prostheses after 30 minutes of implantation. As a result of these findings, 8 more microvenous prosthetic implantations were performed with the sleeve anastomotic technique and evaluated after 24 hours. Six of these prostheses were patent with only minimal exposure of collagenous tissue at the anastomotic sites and subsequently minimal thrombus accumulation. Two prostheses left in situ and evaluated after 3 weeks were then still patent and completely endothelialised. Based upon the present study, we recommend the sleeve anastomotic technique for implanting synthetic microvenous prostheses because this technique prevents extensive exposure of collagenous vessel wall tissue at the anastomoses, thus leading to less thrombus accumulation and subsequently to a higher patency rate.

Anastomosis, Surgical↗
PubMed1991

Percutaneous intrahepatic portosystemic shunt created via a femoral vein approach.

Creation of a percutaneous intrahepatic portosystemic shunt was attempted in a patient with portal hypertension and acute variceal hemorrhage. Abnormal hepatic venous anatomy precluded formation of the shunt with the standard transjugular method. An alternate technique was devised in which a femoral vein approach was used to construct an intrahepatic channel between the inferior right hepatic vein and the right portal vein. The patient stopped bleeding after the procedure and has not rebled during an 8-month follow-up period.

Esophageal and Gastric Varices↗
PubMed1996

Modified heparin-bonded catheter for cannulation of the coronary sinus from the femoral vein.

Serial sampling from the coronary sinus is an attractive technique for drawing blood samples to be used in the characterization of procoagulant activity during coronary interventions. We have developed a modified Simmons catheter for rapid cannulation of the coronary sinus from the femoral approach. The catheter design incorporates heparin bonding and distal side-holes to minimize blood sampling artifacts. Coronary sinus cannulation was performed via the femoral approach in 186 patients by use of a multipurpose catheter (n = 8), an unmodified Simmons I or II catheter (n = 64), or the modified Simmons catheter (n = 114). The coronary sinus was cannulated successfully with the modified Simmons catheter in 97% of patients; the success rate with the unmodified Simmons II catheter was 87% (P = 0.02). The modified Simmons catheter represents an improved technique for cannulation of the coronary sinus from the femoral vein.

Adult↗
PubMed1992

Synergistic antithrombotic properties of G4120, a RGD-containing synthetic peptide, and argatroban, a synthetic thrombin inhibitor, in a hamster femoral vein platelet-rich thrombosis model.

The synergistic antithrombotic properties of G4120, a synthetic Arg-Gly-Asp (RGD) containing peptide which strongly inhibits platelet aggregation, and of Argatroban, a synthetic thrombin inhibitor, were examined in a reproducible quantitative hamster femoral vein platelet-rich mural thrombosis model. Bolus injections of G4120 and Argatroban inhibit thrombus formation in a dose-dependent way; 50% inhibition (ID50) is obtained with 11 micrograms/kg G4120 and with 2 mg/kg Argatroban. Combined bolus injections of 3 micrograms/kg G4120 with 0.5, 0.75 or 1 mg/kg Argatroban and of 1 mg/kg Argatroban with 1.5 or 3 micrograms/kg G4120 caused linear dose-dependent inhibition of thrombus formation, whereas 3 micrograms/kg G4120 or 1 mg/kg Argatroban alone had very little effect (less than 20% inhibition). ID50 was obtained with the combination of 3 micrograms/kg G4120 and 0.5 mg/kg Argatroban, corresponding to an equi-effective fractional combination of 0.62 with a 95% confidence interval of 0.50 to 0.74. Alternatively the ID50 was obtained with the combination of 1 mg/kg Argatroban and 1.3 micrograms/kg G4120, corresponding to an equi-effective fractional combination of 0.52 with a 95% confidence interval of 0.18 to 0.86. In both instances these results are indicative of a significant synergistic interaction. Bolus injection of 10 mg/kg aspirin, 100 U/kg heparin or the combination did not inhibit thrombus formation. The synergistic effect of the combination of platelet inhibiting RGD-peptides and synthetic thrombin inhibitors could be useful in the prevention of arterial occlusion with platelet-rich thrombus in patients with ischemic heart disease following thrombolytic therapy or angioplasty, although this combination is not expected to reverse platelet thrombus formation.

Animals↗
PubMed1992

Adventitial cystic disease of the femoral vein: a case report and review of the literature.

Painless edema of the left leg developed in a 65-year-old man without a history of venous disease, and he was found to have a mass compressing the lumen of the left common femoral vein. The intramural cyst was drained through transvenous exposure and found to contain mucoid material. This is the seventh case of adventitial cystic disease of a vein in the world literature. Analogous to adventitial cystic disease of arteries, it is defined by venography, CT scanning, and duplex ultrasonography. Surgical drainage is the treatment of choice.

Aged↗
PubMed2004

Aortofemoral bypass in young patients with premature atherosclerosis: is superficial femoral vein superior to Dacron?

PURPOSE: Previous studies have documented poor patency rates in "young" patients (age 55 years or younger) with premature atherosclerosis undergoing aortofemoral bypass (AFB) to treat aortoiliac occlusive disease. Given the high reported graft patency rates with superficial femoral vein (SFV) grafts performed because of aortic graft infection, we evaluated the role of SFV grafts for AFB as primary therapy for premature atherosclerosis in a case-control study. METHODS: Over 10 years 31 patients aged 55 year or younger underwent AFB with use of SFV (V-AFB). Case controls consisted of all patients 55 years of age or younger who underwent AFB with use of Dacron (D-AFB) during the same period (n = 80). In all cases this was the initial therapy (no repeat operations). The two groups were well matched for age, sex, weight, preoperative ankle-brachial index, and the comorbid conditions of smoking, coronary artery disease, chronic obstructive pulmonary disease, hyperlipidemia, hypertension, and renal insufficiency. There were more patients with diabetes in the V-AFB group (34% vs 16%; P =.05). Patients in the V-AFB group had more advanced disease, and the surgical indication was more frequently critical ischemia compared with the D-AFB group (90% vs 46%; P <.001). RESULTS: There was only one perioperative death in each group. There were no differences in cardiac, pulmonary, or gastrointestinal complications. However, fasciotomy occurred more frequently with V-AFB (44% vs 1%; P <.001). Surgery time was longer with V-AFB (7.3 vs 4.5 hours; P <.001). Despite these short-term drawbacks, V-AFB proved superior at long-term follow-up. The 5-year primary patency rate was significantly higher with V-AFB than with D-AFB (100% vs 56%; P =.013). There was also a trend for higher limb salvage at 5 years (90% vs 62%). Four graft infections occurred with D-AFB, and none with V-AFB (P =.32). CONCLUSIONS: AFB performed with SFV grafts is a far more durable operation than standard D-AFB in young patients with aortoiliac occlusive disease. However, V-AFB is far more likely to require lower extremity fasciotomy, and takes almost twice as long to perform.

Age Factors↗
PubMed2000

[Autogenous bilateral aortofemoral reconstruction using the popliteal and superficial femoral veins].

The author presents a case-history of a late infection of a bilateral aortofemoral bypass by a coagulase-negative staphylococcus and the definite solution by substitution of the contaminated vascular prosthesis by an anatomical autogenous bilateral bypass made from popliteal and superficial femoral veins. From the technical aspect the operation was very satisfactory without marked peroperative difficulties, the early postoperative course was also favourable, with readily palpable peripheral pulsations, without marked manifestations of venostasis on the lower extremities. From the third postoperative day onwards however progressive manifestations of multiorgan failure developed associated with septic shock and leading to a fatal outcome. Despite this the author considers in patients with a reasonable surgical risk this method of substitution of an infected vascular prosthesis in the aortofemoral region feasible with regard to its resistance to infection and long-term patency, though the operation is technically pretentious but easy to implement.

Aorta, Abdominal↗
PubMed1990

Patency and healing of polymeric microvenous prostheses implanted into the rat femoral vein by means of the sleeve anastomotic technique.

The sleeve anastomotic technique was used to enhance the longer term patency and healing of polyurethane-based (PU) microvenous prostheses (ID: 1 mm, length: 5 mm, wall thickness: 0.2 mm; n = 34) in the rat femoral vein. In the control group, PU prostheses (n = 12) were implanted by means of the conventional end-to-end technique, and all were found to be occluded after one day (n = 6) and three weeks (n = 6). In the other experimental groups, the prostheses were evaluated after one day (n = 6), three weeks (n = 10), and six weeks (n = 18) of implantation by means of routine light- and scanning-electron microscopy. The occluded prostheses in the control group demonstrated a firmly attached mural thrombus at the anastomoses at one day and a completely organized thrombus at three weeks after implantation. Thirty-one of the 34 PU prostheses implanted by means of the sleeve technique were patent. At one day, all patent PU prostheses (five out of six) demonstrated minimal thrombus accumulation and a smooth transition at the anastomotic sites. At three and six weeks, all patent PU prostheses (16 out of 18) were covered by a complete endothelial layer. Underneath the endothelial layer, a subendothelial layer, composed of two to four layers of smooth muscle cells, could be observed. The wall of the prostheses were penetrated by fibrohistiocytic tissue. Stenosis was not observed. These results demonstrate that the sleeve anastomotic technique not only improves the short-term patency of PU microvenous conduits, but also the longer-term patency rate.(ABSTRACT TRUNCATED AT 250 WORDS)

Anastomosis, Surgical↗
PubMed2002

Femorofemoral venous bypass graft for the treatment of venous occlusion of the common femoral vein in a nine year old boy.

Unlike arterial disease, most vascular surgeons have very little experience in performing bypass procedures for venous obstruction especially when occurring in children. Given the lack of published literature when compared to arterial procedures, we report a successful venous crossover procedure following iatrogenic injury and subsequent occlusion of the right common femoral vein in a nine year old boy.

Arteriovenous Shunt, Surgical↗
PubMed1984

Ruptured femoral vein. A complication of the use of gentamicin beads in an infected excision arthroplasty of the hip.

Despite widespread use of gentamicin beads in the treatment of chronic infections of bone and soft tissue, no serious complications have been reported. This report describes a rupture of the femoral vein which occurred during the attempted removal of a chain of beads after radical excision of a chronically discharging Girdlestone arthroplasty. The patient later had a disarticulation at the hip. In the light of our experience with this and other cases we offer some suggestions as to the positioning of gentamicin beads, as well as the timing and method of their extraction.

Aged↗
PubMed1989

[New methods of surgical correction of regional blood flow in combined disorders of the iliac and femoral veins in patients with the post-thrombophlebitis syndrome].

The indications for the performance of reconstructive operations were established on the basis of findings of Doppler ultrasound, occlusive plethysmography, polarography, measurement of the rate of muscular blood flow by means of Na 131I and functional-dynamic phlebography. In surgical treatment of 5 patients, the recanalized superficial femoral vein was used as a suprapubic shunt, in 4--suprapubic shunting was combined with transfer of the great saphenous vein segment of a healthy lower extremity with ostial valve to the position of the popliteal vein. Good results were obtained in 7 cases.

Femoral Vein↗
PubMed2004

Diaphragm-like membrane causing common femoral vein obstruction: case report.

A 23-year-old woman had exercise-induced right leg symptoms. An extensive diagnostic workup including 2 surgical explorations was performed, but did not reveal the cause. Finally, high-resolution color-coded duplex scanning was performed, which demonstrated an isolated, nonthrombotic obstruction of the common femoral vein by a diaphragm-like membrane. Successful operative repair was accomplished with venotomy and excision of the membrane, with full relief from clinical signs and symptoms at 9-month follow-up.

Adult↗
PubMed1992

Broviac central venous catheters inserted via the saphenous or femoral vein in the NICU under local anesthesia.

We present our experience with 92 Broviac central venous catheters inserted into 84 infants over a 31-month period. Our technique specifies placement in the neonatal intensive care unit under local anesthesia, with insertion to the inferior vena caval-atrial junction via the saphenous or femoral vein, with a subcutaneous tunnel to an exist site on the anterior thigh. We conclude this technique to be safe, efficient, convenient, cost-effective, and minimally uncomfortable to the infant, with no increase in morbidity or mortality in comparison to previously described methods.

Anesthesia, Local↗