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At least 127 records · Page 7Linked to original sources
PubMed2001

Permanent pacemaker implantation via the femoral vein: an alternative in cases with contraindications to the pectoral approach.

BACKGROUND: This paper presents a consecutive series of permanent pacemakers (PPM) implanted via the femoral vein in patients with contraindications to pacing systems via the superior vena cava (SCV). The femoral vein approach is a less invasive and feasible alternative to epicardial lead placement. METHODS: Twenty-seven patients had femoral pacemakers inserted. Indications for femoral vein pacemaker insertion were: SVC/subclavian obstruction (12 patients, 44.4%), previous infection in SVC leads (four patients, 14.8%), mastectomy and/or radiotherapy to chest (four patients, 14.8%), multiple leads in SVC (two patients, 7.4%), recurrent erosion (two patients, 7.4%), abnormal anatomy (one patient, 3.7%), painful pacemaker pocket (one patient, 3.7%) and burns (one patient, 3.7%). Fifty-one leads, 25 atrial and 26 ventricular, were inserted. The majority of leads were active fixations (96% of atrial leads and 85% ventricular leads). RESULTS: During a mean follow-up of 36.5 months (range 0.9-116.5), six additional unplanned procedures were performed in four patients. Atrial lead displacement occurred in five leads (20%). There were no ventricular lead displacements. In two patients, box revision for pre-erosion was required. One patient had persistent pain at the site of abdominal pacemaker generator. Infection, thromboembolic events, thromophlebitis, evidence of lower limb venous occlusion and lead fracture did not occur. CONCLUSION: Femoral vein PPM are a simple and feasible alternative in patients in whom the SVC approach is contraindicated.

Adult↗
PubMed2004

Bilateral lumbosacral plexopathy after femoral vein dialysis: synopsis of a case.

Femoral vein dialysis is a technique applied in many clinics. Hemorrhagic complications following the procedure either directly due to the femoral catheterization itself in the early period or less with concomitant late neurological impairments may pose serious challenges to the clinician. Likewise in this report, we are presenting a dialysis patient with bilateral retroperitoneal hematomas causing bilateral lumbosacral plexopathies-to our best knowledge the first in the literature. We have also touched upon its prompt diagnosis and treatment.

Catheterization↗
PubMed2003

Effects of ankle exercise combined with deep breathing on blood flow velocity in the femoral vein.

Ankle exercises are commonly used to facilitate venous return in the lower extremity and to prevent deep vein thrombosis. Moreover, the respiratory cycle affects venous return. This study examined the effects of ankle exercise combined with deep breathing on the blood flow velocity in the femoral vein. Twenty healthy males (mean age 21.3 years), who had no medical history of lower extremity disease, were recruited for this study. The blood flow velocity in the femoral vein was measured while performing four exercise protocols: quiet breathing while resting (QR), deep breathing (DB), ankle exercise with quiet breathing (AQB), and ankle exercising combined with deep breathing (ADB). Using a Doppler ultrasound with an 8 MHz probe, peak blood flow velocities were collected for a 20 second period at the start of the inspiration phase in each protocol, three times. There were statistically significant differences in the peak blood flow velocity in the femoral vein with the four protocols (p lt 0.001). The mean (SD) peak blood flow velocity in the femoral vein was as follows: QR 10.1 (4.2) cm/sec, DB 15.5 (3.9) cm/sec, AQB 20.7 (6.6) cm/sec, and ADB 26.5 (9.4) cm/sec. Post hoc analyses revealed significant differences between each of the four protocols (p(adj) lt 0.01). The mean peak blood flow velocity in the femoral vein was greatest with the ADB protocol, which implies that the ADB protocol may be useful to prevent the blood stasis in patients at risk of deep vein thrombosis.

Adult↗
PubMed1989

[Phlebographic observations on the morphology and function of the femoral vein and its valves].

The morphology and function of the femoral vein and its valves in normal and abnormal groups were analysed and compared in 334 cases (414 lower limbs) by ascending and descending phlebography. The diagnostic criteria were established in the normal and abnormal femoral vein and its valves using statistical analysis. Three types of the femoral valvular incompetence were proposed and the value of ascending and descending phlebography in the diagnosis of femoral valves was discussed.

Adult↗
PubMed2002

Closure of the femoral vein puncture site after transcatheter procedures using Angio-Seal.

The use of anchor-based, collagen-derived vascular sealing devices in femoral vein punctures during right and left heart catheterizations or coronary interventions necessitating venous access for temporary pacemaker or hemodynamic monitoring has not been studied. We hypothesized that using these devices in the femoral vein would be practical and reliable. One hundred and ten consecutive patients undergoing right and left heart catheterization (56 patients, 51%) or coronary intervention (54 patients, 49%) were included in this study. Forty-five of the interventions received IIb/IIIa inhibitors in combination with heparin, enoxaparin, aspirin, and clopidogrel. The Angio-Seal device was successfully deployed in the femoral vein in all patients, whereas 93 (85%) received arterial Angio-Seal, 8 received Perclose, and 9 (8%) had manual pressure or a Fem-Stop applied to control arterial bleeding after deployment. We conclude that in patients undergoing transcatheter procedures requiring venous access, the use of an 8 Fr Angio-Seal to seal the femoral vein is safe and feasible.

Adult↗
PubMed1998

Superficial femoral vein in arterial reconstruction for limb salvage: outcome and fate of venous circulation.

BACKGROUND: In some particular cases in vascular surgery it is mandatory to perform arterial reconstruction using autologous graft. Since 1985, we have been using the superficial femoral vein for arterial substitute in the case of limb salvage, when another autologous vein has not been available. We made a prospective investigation on 32 patients over a mean period of 24.5+/-12.1 months (1 to 48 months) to evaluate the usefulness of superficial femoral vein (SFV) for distal arterial reconstructive surgery and to objectify the fate of venous circulation of the limb after removal of this vein. METHODS: There were 20 male and 12 female patients averaging 64.3+/-10.3 years, who underwent crural arterial reconstructive surgery using the composite technique (PTFE and SFV). All grafts had been placed subcutaneously in lateral to knee position. Mean length of removed superficial femoral vein was 13.2+/-9.4 cm. RESULTS: In 6 patients (18.7%), we found an early occlusion of bypass followed by major amputation in 5 cases (15.6%). Minor amputation had to be done in 12 patients (37.5%). Cumulative patency was 56.3% after 48 months. Following the removal of superficial femoral vein, we had no complications due to venous stasis. We found a significant increase of plethysmographically measured venous capacity (1.7+/-0.49 to 2.51+/-0.71 [p<0.01]) and venous outflow (14.9+/-5.34 to 23.9+/-10.4 [p<0.05]) after 7.7 months. We did not observe more significant changes of venous circulation during further follow-up. CONCLUSIONS: Despite overall good results, we only recommend the use of superficial femoral vein in hazardous situations, when other autologous material is not available.

Amputation, Surgical↗
PubMedDate not supplied

[Iatrogenic traumatic lesions of femoral veins during varicose veins surgery].

Traumatic lesions of the femoral veins during varicose veins surgery are very uncommon and they raise several therapeutic difficulties. They occur in 1/1000 cases of varicose veins operated. The authors describe four cases of lesions of this type that were seen and treated for the last six years, probably because there was an increase in the number of varicose veins operated on in the Lisbon area. The authors discuss the surgical options and they concluded that these complications can be minimized with good anatomical and surgical skills, specially of the saphenous-femoral and saphenous-popliteal junctions.

Adult↗
PubMed2005

Latex D-dimer signal in in situ femoral vein thrombus in swine and effect of minidose exogenous tissue plasminogen activator bolus.

STUDY OBJECTIVES: We created in situ femoral vein thrombi in swine to investigate the response of the latex d-dimer signal to acute in situ venous thrombosis, and to determine the minimum dose of exogenous bolus tissue plasminogen activator (t-PA) required to significantly elevate the d-dimer signal. STUDY DESIGN: We studied seven swine (20 to 22 kg) under pentobarbital anesthesia. A 6-cm segment of the proximal femoral vein was surgically exposed and briefly ligated. Thrombin, 250 U, was then injected into the isolated femoral vein segment to create an in situ clot. After clot formation was documented to be complete between the ligatures, they were then released. D-dimer levels were then measured every 15 min for 1 h before and 1 h after clot formation with ligatures released. Time-response curves to establish timing of peak t-PA effect were performed, and then escalating dose-response curves of d-dimer level to minidose t-PA were plotted. RESULTS: After formation of the clot, the release of ligatures resulted in no change in d-dimer levels over 1 h (p = 0.62) in all swine. When a time-response curve to exogenous t-PA bolus in the presence of femoral clot was plotted, there was a maximal increase in d-dimer signal at 30 min after bolus t-PA administration. The subsequent dose-response curves for escalating fivefold boluses of minidose t-PA showed an increase in d-dimer signal at doses of 0.8 mg (p = 0.03) and 4 mg (p = 0.003). CONCLUSION: We conclude the following: (1) in situ femoral vein clot formation does not elevate d-dimer signal for 1 h after ligature release; (2) minidose t-PA boluses of 0.8 mg and 4 mg significantly elevated the latex d-dimer signal above baseline; and (3) there is a potential role of minidose t-PA in enhancing the d-dimer signal in in situ deep venous thrombosis.

Animals↗
PubMed2005

Intravascular synovial sarcoma of the external iliac vein and reconstruction with the superficial femoral vein.

Intravascular synovial sarcoma is a rare neoplasm that arises in large veins of the junctional zone between the proximal leg and lower trunk in adult women. Herein we report the first case of an intravascular synovial sarcoma of the external iliac vein. It was successfully treated with neoadjuvant radiotherapy, radical excisional surgery, and combined arterial and venous reconstruction. Intravascular synovial sarcoma should be considered in the differential diagnosis of any adult woman with deep venous thrombosis and a mass of the femoral or iliac venous system.

Female↗
PubMed1977

Endometriosis involving the femoral vein.

The first case of endometriosis of the femoral vein presenting as a femoral hernia is reported. Histogenesis and sites of extragenital endometriosis are briefly reviewed.

Adult↗
PubMed1977

Femoral vein thrombosis and total hip replacement.

Of 160 patients who underwent total hip replacement, 81 developed venographic evidence of thrombi in the operated leg. In 46 cases (57%) the thrombus originated from the femoral vein, and in 43 of these the exact site of origin was defined by venography. In 34 cases (74%) the thrombus arose from the wall of the femoral vein at the level of the lesser trochanter. This region was studied by intraoperative venography in eight patients undergoing total hip replacement, and in every case severe distortion of the common femoral vein was observed, producing almost total occlusion. We suggest that intraoperative damage to the femoral vein results from manipulation of the leg, and that this is one reason why the operation is followed by a high incidence of deep vein thrombosis in the upper femoral region.

Femoral Vein↗
PubMed1997

When the common femoral vein is revealed as flattened on spectral Doppler sonography: is it a reliable sign for diagnosis of proximal venous obstruction?

OBJECTIVE: The purpose of the study was to determine if a monophasic waveform with no response to Valsalva's maneuver in the common femoral vein on spectral Doppler sonography is reliable for the diagnosis of proximal venous obstruction. SUBJECTS AND METHODS: In a prospective study from January 1993 through October 1995, 37 of 2138 cancer patients examined with duplex Doppler sonography exhibited monophasic flow in the common femoral vein on spectral Doppler imaging and no response to Valsalva's maneuver. These 37 patients were further evaluated with an abdominal and pelvic CT scan with IV contrast medium (n = 23), with sonography (n = 8), with MR imaging (n = 4), with venography (n = 1), or by both venography and CT (n = 1) to determine the cause of monophasic flow in the common femoral vein and lack of response to Valsalva's maneuver. All follow-up imaging studies were obtained from 0 to 30 days after initial duplex Doppler sonography. RESULTS: All patients with monophasic flow in the common femoral vein on spectral Doppler imaging and no response to Valsalva's maneuver had proximal venous extrinsic compression or deep venous thrombosis. Twenty-nine (78%) of 37 patients had extrinsic compression. Such compression was caused by pelvic masses in 15 (41%) of 37 patients, enlarged nodes in eight patients (22%), and postsurgical changes in six patients (16%). The remaining eight patients (22%) had proximal deep venous thrombosis. CONCLUSION: On spectral Doppler sonography, monophasic waveform with no response to Valsalva's maneuver in the common femoral vein is a dependable sign for the diagnosis of proximal extrinsic compression or deep venous thrombosis. If such a waveform is identified, further investigation is warranted.

Constriction, Pathologic↗
PubMed1986

Alpha-1 and alpha-2 adrenoceptor: response coupling in canine saphenous and femoral veins.

The aim of the present study was to analyze alpha-1 and alpha-2 adrenoceptor response coupling in isolated canine blood vessels. Rings of saphenous and femoral veins and of femoral arteries were suspended for isometric tension recording in modified Krebs-Ringer bicarbonate solution, gassed with 95% O2-5% CO2 and maintained at 37 degrees C. Dissociation constants for the alpha-1 adrenergic agonists, phenylephrine and cirazoline, and the alpha-2 adrenergic agonist, UK 14,304, were determined by analysis of concentration-effect curves to the agonists under control conditions and after partial inactivation of alpha adrenoceptors by phenoxybenzamine. The dissociation constant of phenylephrine for alpha-1 adrenoceptors in saphenous veins was approximately 10-fold higher than that obtained for the agonist in femoral arteries or femoral veins. Similarly the dissociation constant for cirazoline in the saphenous vein was higher than that obtained in other alpha-1 adrenergic systems. Dissociation constants were used to determine alpha adrenoceptor occupancy-response relationships. The alpha-1 adrenergic responses evoked by high intrinsic-efficacy agonists (cirazoline and phenylephrine) were associated with a very large receptor-reserve in the saphenous vein, but no, or only a limited receptor-reserve in the femoral vein. The dissociation constant for UK 14,304 in saphenous veins was significantly lower than that obtained for alpha-2 adrenergic stimulation by norepinephrine. There was no alpha-2 adrenoceptor reserve in the saphenous vein for these putative high intrinsic-efficacy agonists. The differences in receptor-reserve between alpha-1 adrenoceptors in canine saphenous and femoral veins and between alpha-1 and alpha-2 adrenoceptors in saphenous veins may help to explain the differential modulation of adrenergic responses in these blood vessels.

Animals↗
PubMed1979

Neurogenic constriction of the superior mesenteric and femoral veins during systemic blood pressure oscillation in rabbits.

Behavior of the mesenteric and femoral veins was studied in rabbits during an arterial pressure oscillation elicited by a method that we call the "side pressure exertion experiment." A segment of the mesenteric or femoral vein with intact innervation was vascularly isolated and was perfused under an isovolumetric condition. The force of the isovolumetric constriction of the segments was recorded in terms of the intrasegmental pressure duirng arterial pressure oscillation. The intrasegmental pressure of the superior mesenteric vein indicated an alternation of marked rise and fall during the oscillation. On the other hand, the response of the femoral segment during oscillation was less phasic but was better maintained at the higher range of initial pressures than that of the superior mesenteric segment. Simultaneously with the maximum rise of systemic arterial pressure, maximum elevation by 6.1, 6.1 and 6.4 mmHg was obtained in the mesenteric vein segment at initial intrasegmental pressures of 6, 10 and 14 mmHg, respectively. In the same circumstances, the femoral vein segment indicated a maximum rise of 8.1 to 9.3 mmHg at initial pressures of 10, 18, 26 and 34 mmHg. It can be concluded that there are marked differences between the mesenteric and femoral segments in behavior during systemic arterial oscillation and in the range of bearable intrasegmental pressure. The characteristics of the two veins might be related to the difference of specific circumstances in which the respective veins send blood back to the heart.

Animals↗
PubMed1982

Platelet counts in blood taken from femoral artery, femoral vein, cubital vein, and arteriovenous fistula.

In 20 patients under regular dialysis with an arteriovenous fistula in one forearm, platelet counts were measured in blood taken simultaneously from the cubital vein, the arterialized vein near the site of anastomosis, the femoral vein, and the femoral artery. Samples of blood from the fistula and from the cubital vein of the opposite limb were taken with and without stasis. The highest values were found in blood taken from the cubital vein without stasis. Platelet counts were identical in femoral artery and vein, but were 4.8 and 4.9%, respectively, lower than the cubital vein values. Platelet counts from fistula blood taken without stasis were 13.7% lower than in the cubital vein. Platelet counts were lower when samples of blood were taken with stasis: 11.2% in the cubital vein, 7.4% in fistula blood. The awareness of these differences is of practical importance for platelet behavior studies.

Arm↗