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At least 145 records · Page 8Linked to original sources
PubMed1998

[Central venous access via the distal femoral vein using ultrasound-guidance].

We used a new method for central venous (CV) access via the distal femoral vein using ultrasound guidance in two cases. In the first case, because of multiple catheter punctures for hemodialysis previously, femoral catheter placement was impossible using a standard landmark technique. In the second case of laryngoplasty, it was also impossible to place a CV catheter at usual groin sites because of extensive mycosis. In these two cases, we attempted CV catheterization via the distal femoral vein at the femur (10 cm from the inguinal ligament) by using ultrasound guidance. In both cases the catheter placement was easy and took a short time. No complication due to puncture and catheterization was observed. CV access via the femoral vein in the groin has been the first-choice for the patients undergoing neuro- or neck-surgery. However, the femoral CV catheters at inguinal site has been associated with higher incidence of catheter infection than the subclavian or internal jugular vein. These methods have a potential for decrease in catheter infection rate. These two case reports suggest that the CV catheterization at distal femoral site by ultrasound-guidance is useful as a new method of CV access.

Aged↗
PubMed1984

Diagnosis and management of retroperitoneal hematomas after femoral vein cannulation for hemodialysis.

Six patients were identified who suffered retroperitoneal hemorrhage during or after hemodialysis via a femoral vein approach. Hypotension developing during dialysis or lower quadrant abdominal pain was the common presenting symptom. All patients had decreasing hematocrits and five of the six patients required blood transfusions. The method of diagnosis was clinical, with plain abdominal x-ray examination and cystography being the most helpful adjuncts. All patients were successfully treated with volume resuscitation and removal of the femoral vein catheters; none required operative intervention or suffered adverse late effects. Femoral vein dialysis is useful for uremic patients without other peripheral vascular access options, and its associated morbidity may be minimized provided complications are recognized and promptly treated.

Adult↗
PubMed1983

Effects of lumbar epidural analgesia and general anaesthesia on flow velocity in the femoral vein and postoperative deep vein thrombosis.

The effect of lumbar epidural analgesia and of general anaesthesia on the peroperative velocity of flow in the femoral vein was measured with Doppler ultrasound technique in 38 patients undergoing retropubic prostatectomy. The patients were randomly allocated to the epidural or the general procedure. The 125I-fibrinogen test was used to detect deep vein thrombosis (DVT). Epidural analgesia was associated with a significant (ca. 120%) increase in the femoral venous flow velocity. The peak flow showed a moderate (47%) increase, whereas the minimum flow was greatly increased (188%). The increase was significant already 2 min after induction of the analgesia and the rate continued to rise for about 11 min. General anaesthesia significantly reduced the flow velocity in the femoral vein. Immediately after induction of the anaesthesia the velocity approached zero, but gradually rose, and after about 8 min was stabilized at level 40% below the preoperative velocity. The peak flow velocity in all patients of this group fell by 24 to 40%. Only 2 of 17 patients with epidural analgesia, but 11 of 21 with general anaesthesia had postoperative DVT. In the 11 patients with DVT the mean minimum velocity of flow was decreased (by 85%), but in the 10 without DVT it was increased (by 175%). The difference was not statistically significant. Increased velocity of flow in the femoral vein, especially of minimum flow, seems to counteract development of DVT.

Anesthesia, Epidural↗
PubMed2006

An unusual case of synovial cyst of the hip joint presenting as femoral vein compression and severe lower limb edema.

INTRODUCTION: Synovial cyst of the hip joint causing the compression of the femoral vein is a rare occurrence. We carefully reviewed the international literature collecting 26 additional cases. REPORT: A case of a patient affected with synovial cyst of the hip joint causing the compression of the femoral vein and severe lower limb edema is presented. DISCUSSION: The treatment of choice of synovial cyst compressing the femoral vein is surgical removal.

Aged↗
PubMed2002

Use of superficial femoral vein in the treatment of infected aortoiliofemoral prosthetic grafts.

PURPOSE: To assess the use of the superficial femoral vein for the reconstruction of the aortoiliofemoral sector in the treatment of prosthetic infections. METHODS: From December 1995 to November 1999, 12 patients with infection involving a synthetic vascular prosthesis were submitted to thirteen surgical procedures involving partial or total resection of a synthetic vascular prosthesis and restoration of arterial flow with an in situ femoral vein. RESULTS: The overall operative mortality rate was 15.3% (2 out of 3 patients who underwent total graft replacement and 0 out of 9 patients who underwent unilateral graft replacement). Major amputations related to the surgical procedures were performed in two cases (an 87.5% rate of limb salvage). The series was followed up on average for 22 months (range: 6-65 months). No patient presented clinically significant edema or signs of chronic venous insufficiency in the lower limbs used as donors of autogenous venous grafts. All surviving patients presented complete resolution of the infectious signs and symptoms and none of them presented late thrombosis of the venous graft. CONCLUSION: The use of the superficial femoral vein is a good surgical alternative for the treatment of prosthetic infections with minimal venous morbidity of the lower limbs used as venous graft donors. The autogenous venous grafts present good long-term patency and excellent adaptation to the aortoiliofemoral position.

Adult↗
PubMed1987

Catheterization of the femoral vein for chronic hemodialysis.

Over the last ten years (1976-1986), 3,041 hemodialyses have been performed with 6,082 femoral vein catheterization in 336 patients with chronic renal failure. In the 3,041 hemodialyses, severe hematoma (0.29%), superficial hematoma (5.55%), and retroperitoneal hematoma (0.06%) have been observed. In 29 patients whose hemodialyses have been performed successively with femoral vein catheterization over a period of three to twelve months, subcutaneous fibrosis was observed in 24 and femoral vein regional narrowing was seen in 2.

Catheterization, Peripheral↗
PubMed2003

Transvenous liver biopsy via the femoral vein.

AIM: To study the safety, effectiveness and diagnostic value of transvenous forceps biopsy of the liver in 54 patients with coagulopathy, gross ascites or morbid obesity and suspected liver disease in whom percutaneous liver biopsy was contraindicated. MATERIAL AND METHODS: Forceps biopsy of the liver via the femoral vein was attempted in 54 adult patients with advanced liver disease of unknown aetiology who had coagulation disorders (41 cases), gross ascites (11 cases) or morbid obesity (two cases). In each patient two to six biopsies (average four) were taken using a radial jaw forceps inserted via the right or left femoral vein. RESULTS: The procedure was successful in 53 cases. Hepatic vein catheterization failed in one patient. Adequate liver tissue for diagnosis was obtained in 84% of cases. One patient developed delayed haemorrhage at 12 h from a capsular leak that was undetected during the biopsy procedure. This patient required blood transfusions and laparotomy to control bleeding. There were no deaths in the 53 patients studied. Transient minor chest and shoulder pain was encountered during sheath insertion into a hepatic vein in 23 patients. Three patients developed a femoral vein haematoma, which resolved with conservative treatment. CONCLUSION: Transvenous liver biopsy via the femoral vein is another safe, effective, simple alternative technique of biopsy when the percutaneous route is contraindicated.

Adult↗
PubMed1986

Influence of dihydrolysergic acid amide on serotonergic and alpha-adrenergic receptors in human blood platelets and femoral veins in vitro.

The effect of dihydrolysergic acid amide (DLSA) on responses of human blood platelets and isolated postmortem femoral veins to serotonin and catecholamines was studied in vitro in comparison to dihydroergotamine (DHE). DLSA inhibited the 5-HT-potentiated, ADP-induced platelet aggregation in approximately the same concentration range as DHE. It was three orders of magnitude less potent in inhibiting the adrenaline-induced aggregation and specific binding of 3H-yohimbine to intact platelets than DHE. In femoral vein strips, DLSA caused an increase in tone in the same concentration range (0.01-1.0 mumol/l) as DHE; however, its efficacy was somewhat lower. At concentrations of 0.1 to 1.0 mumol/l it antagonized the 5-HT-induced contractile response in a noncompetitive manner, the antagonist potency being one order of magnitude lower than that of DHE. DLSA (1 mumol/l) did not inhibit the noradrenaline-induced venoconstriction. The results show that DLSA possesses agonist activity in femoral veins and 5-HT-antagonist activity in platelets and veins.

Binding, Competitive↗
PubMed1991

The acute and chronic effects of G-lasing on femoral vein grafts in dogs.

Each year, 5% of all coronary artery bypass operations are repeat procedures, and 15%-30% of coronary artery vein grafts occlude within the first eighteen months postoperatively. To evaluate the macroscopic and histologic effects of G-lasing on vein grafts and their patency, femoral veins were used to bypass bilaterally induced stenoses of femoral arteries in 10 dogs. The left vein grafts were G-lased with a 1.5 mm, hot-tipped argon laser at 5 watts for ninety seconds, while the right grafts were used as the controls. Acutely, each vein graft demonstrated no evidence of charring or perforation. The percentage of endothelium present in the G-lased vein grafts was consistently less than 5%, whereas the control vein grafts had an average of 70%. After ten weeks, the animals were sacrificed, and the vein grafts were evaluated for histologic changes and patency. There were no significant microscopic differences between the G-lased and control vein grafts. A statistically significant difference in graft patency was not achieved between G-Lased and control vein grafts at 10 weeks, but only a small number of grafts were studied. Further studies will be needed to evaluate the effects of G-lasing on the long-term patency of vein grafts.

Angioplasty, Laser↗
PubMed2000

Correlation of central venous pressure with Doppler waveform of the common femoral veins.

The objects of this prospective study were to determine the nature of the flow in the right femoral vein and to correlate the flow velocity with the venous pressure measured in the right atrium. We performed 236 pulsed Doppler ultrasonographic examinations in 1 year on patients with a venous catheter with the distal tip in the right atrium. In the Doppler wave readouts we analyzed wave frequency, velocity components, and relationships among them and the existence of pulsatile flow. These parameters were then compared to the right atrium pressure. We investigated the correlation between the atrium pressure and the flow velocity obtained from the Doppler waveforms of the common femoral veins, obtaining a significant correlation (P<0.0001) with the following: the atrium systolic wave a, the atrium diastolic wave v, the pulsatility ratio (PR = Vmin/Vmax) and the pulsatility index (PI = [Vmax - Vmin] /Vavg). The receiver operating characteristic showed that the pulsed Doppler ultrasonography is not a sensitive technique in diagnosis high atrium pressures. In addition, both cardiac and respiratory phasicity of the venous wave was observed. A significant inverse relation was found between the pulsatile flow and high atrium pressure. Nonetheless, the low sensitivity of this technique does not allow the use of pulsatile Doppler ultrasonography in the common femoral vein for diagnosing increases of the atrium pressure.

Adolescent↗
PubMed1993

Successful use of indwelling cuffed femoral vein catheters in ambulatory hemodialysis patients.

Three hemodialysis patients with multiple upper extremity vascular access complications and central vein stenosis were treated for as long as 3 months using an indwelling femoral vein catheter having a buried felt cuff in its subcutaneous tunnel. Four catheters were placed in these three patients. In one case, initial failure due to poor flow and clotting occurred using a straight catheter with its tunnel crossing the inguinal ligament and exiting caudally on the anterior thigh. Otherwise, each patient had successful placement of a 180-degree, curved catheter that exited the femoral vein in the usual fashion but had a subcutaneous tunnel and skin exit pointing cephalad in the inferior portion of the right lower quadrant. The three successful devices functioned immediately after placement, having acceptable outflow pressures and recirculation values. One of three catheters was removed 3 weeks after placement when persisting infection was thought to reside on the device. No other bleeding, thromboembolic, or infectious complications occurred in these patients. In conclusion, short-term indwelling femoral vein access may be feasible in ambulatory hemodialysis patients with previous access difficulties that complicate temporary dialysis treatment.

Adult↗
PubMed2002

Effect of simulated weightlessness on pressure-volume relationships of femoral veins in vivo of New-Zealand rabbits.

OBJECTIVES: To observe the change of pressure-volume relationships of femoral veins of rabbits after simulated weightlessness. METHODS: Head-down tilt(HDT) -20 degrees rabbit model was used to simulate weightlessness .24 healthy male New-Zealand Rabbits were randomly divided into 21d HDT group, 10d HDT group and control group, with 8 in each. The pressure-volume relationships of rabbits femoral veins were measured. RESULT: The femoral vein P-V relationship curves of HDT groups were shifted to larger volume change ratio than that of control group. The P-V relationship curve of the 21d HDT group was shifted more obviously than that of HDT-10d. B1 and B2 in quadratic equations of 21d HDT group were significantly higher than these value of 10d HDT group and control group during expansion (inflow) and collapse (outflow) (P<0.01). CONCLUSIONS: The femoral venous compliance increased after weightlessness simulation and the femoral venous compliance of 21d-HDT increased more obviously than that of 10d-HDT.

Comparative Study↗
PubMed1984

Quantification of platelet retention in aortocoronary femoral vein bypass graft in dogs treated with dipyridamole and aspirin.

Autologous femoral vein segments were implanted as aortocoronary bypass grafts in 50 dogs, 25 of which were treated with dipyridamole and aspirin to inhibit platelet deposition and 25 that were not. Autologous platelets labeled with indium-111 were injected into some dogs 48 hr before they were killed on the first day after surgery; other dogs were injected 24 hr before they were killed (3, 7, 30, and 90 days after surgery). Radioactivity on the grafts and on control specimens of contralateral femoral veins was converted to quantification of platelets adhering to the vessel wall (platelets/cm2). The treated group had fewer graft platelets per square centimeter than the untreated group on postoperative days 3, 7 (p less than .01), and 30 (p less than .05). Graft and control vein platelets per square centimeter were nearly equal by day 90. Comparison of graft and control specimens by scanning electron microscopy nearly equal by day 90. Comparison of graft and control specimens by scanning electron microscopy revealed deendothelialization at 1 and 7 days after grafting and reendothelialization at 30 and 90 days. The data suggest that indefinite prolongation of therapy to inhibit platelet deposition after bypass grafting may be unnecessary (although other atherosclerotic vessels may benefit from therapy).

Animals↗
PubMed2005

[Morphological changes in femoral vein wall structure in presence of persistent vertical reflux].

The article contains an analysis of different mechanisms of persistent chronic venous insufficiency formation and its impact on the condition of lower extremity magistral vein wall. The authors studied autopsy samples of femoral vein segments from 86 patients aged 56 to 64 years, who had died of non-cardiovascular diseases. The investigation revealed significant changes in the vein wall structure, associated with persistent overload caused by valvular insufficiency and continuous persistent vertical reflux. At the same time, valve cusp structure remodels. Histological studies show that the overload of the system of deep femoral vein segment primarily increases the bulk of longitudinal smooth muscle cells, which fulfill the main contractile function in contrast to circular smooth muscle cells, performing the tonic function. Further overload of all vein wall structures results in structural alterations, smooth muscle cell hypertrophy, forming of longitudinal smooth muscle cell fascicle, and finally, their dystrophic changes. These processes bring about clinical presentations of chronic venous insufficiency.

Cadaver↗
PubMed1979

Early failure of expanded polytetrafluoroethylene in femoral vein replacement.

Grafts of expanded 30-mu fibril length polytetrafluoroethylene (PTFE) were inserted as segmental femoral vein replacements in nine dogs. The contralateral femoral vein served as a control, receiving a graft from each dog's right external jugular vein. Graft patency was monitored for 24 weeks postoperatively with serial venograms and venous pressures of the operated limbs. All expanded PTFE grafts and one autogenous graft thrombosed within 24 to 48 hours. Significant venous hypertension in the extremities receiving the PTFE grafts persisted for six months.

Animals↗
PubMed2002

Implantation of cryopreserved allograft pulmonary monocusp patch to treat nonthrombotic femoral vein incompetence.

We implanted cryopreserved allograft monocusp patches made from cadaveric pulmonary arteries to correct nonthrombotic valvular insufficiency of the common femoral vein in patients with chronic venous ulcers. Thirty-eight patients with 40 ulcers of longer than 3 years' duration underwent valvular repair of the common femoral vein from September 1995 through November 2001. We studied ulcer healing and competence of the monocusp patches using duplex ultrasonography Three patients with a total of 4 ulcers were lost to follow-up; therefore, 35 patients with 36 ulcers were available for examination. Twenty-four ulcers healed, and 12 did not. Of the 24 healed ulcers, 5 recurred. Four of the 5 ulcers were treated, 3 by monocusp patch replacement and 1 by iliac vein dilation and stenting. All such recurrent ulcers healed. The 5th recurrent ulcer was not treated, because the patient refused therapy Therefore, of the 24 ulcers that healed initially, 23 were healed at the end of the study Of the 12 unhealed ulcers, 4 were treated: 2 by ligation of incompetent perforating veins, 1 by saphenous vein ligation and partial stripping, and 1 by monocusp replacement. All 4 ulcers healed. The other 8 patients, all of whom had severe monocusp insufficiency, refused therapy. Therefore, of the 12 ulcers that did not heal initially, 4 were healed after additional treatment. No implanted monocusp patch developed clots. The ulcers remained healed when the prostheses remained competent. We conclude that monocusp patches can restore valvular competence to the femoral vein in patients who have primary valve insufficiency. In such patients, venous ulcers heal rapidly after prosthesis implantation if the monocusp remains competent and if there is no severe incompetence of the superficial venous system or of perforating veins.

Aged↗
PubMed2002

Biomechanical response of femoral vein to chronic elevation of blood pressure in rabbits.

Venous diseases like iliofemoral deep vein thrombosis and valvular dysfunction induce venous hypertension. To know the effects of the hypertension on venous mechanics, blood pressure in the left femoral vein in the rabbit was chronically elevated by the constriction of the left external iliac vein. Wall dimensions and biomechanical properties of the femoral vein were studied in vitro at 1, 2, or 4 wk after surgery. Blood pressure measured immediately before the animal was killed was significantly higher in the left femoral vein than in the sham-operated, contralateral vein. Wall thickness was increased by blood pressure elevation even at 1 wk, which restored circumferential wall stress to a control level. The stress was kept at normal up to 4 wk. Vascular tone and vascular contractility were increased by the elevation of blood pressure; however, wall elasticity and compliance were kept at a normal level. These results are very similar to those observed in hypertensive arteries, indicating that not only arteries but veins optimally operate against blood pressure elevation.

Animals↗