41,350 research outputs found

    Varicosities affecting the lower limb veins consequent to a unique variant drainage pattern of the small saphenous vein

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    We report varicosities affecting the right deep femoral vein and the right femoral vein consequent to a unique unilateral variation in the course of the small saphenous vein. The right small saphenous vein, instead of draining into the popliteal vein at the popliteal fossa, expanded considerably in girth and thickness and continued as the deep femoral vein. The deep femoral vein then pierced the adductor magnus muscle, appeared in the anterior compartment, and joined the femoral vein. Four centimeters distal to this junction, a two-centimeter long varicosity in the deep femoral vein was noted. There was also a one-centimeter long varicosity on the femoral vein at its point of attachment to the deep femoral vein. The abnormal course of the small saphenous vein has several clinical implications, including pathogenesis and treatment of varicose veins, planning of coronary artery bypass grafting, and pathogenesis of venous thrombosis and pulmonary embolism

    A rare case of anatomical variation of the femoral artery and vein

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    During a dissection of the two femoral trigons in a female corpse, about 14 years old, we discovered on the right side, the deep artery of the thigh arising from the medial side of the femoral artery and passed in front of the femoral vein above the mouth of the great saphenous vein; on both sides, there was the presence of a collateral canal which communicated the external iliac vein with the femoral vein on the right, on the left, it communicated the external iliac vein with the quadricipital vein. The lower part of the femoral vein was duplicated on both sides, but on the right, there was an interconnecting channel between the two trunks of the duplication. Variations of the femoral vessels are very frequent and can be responsible for an incident during the practice of certain gestures at the level of the femoral trigon such as: catheterization of the femoral artery or vein, the treatment of femoral hernias. Key words: Deep thigh artery, collateral venous canal, external iliac vein, anatomic variations

    Venous obstruction of the thigh

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    A case of femoral vein thrombosis is described by 3D spiral CT

    An interconnected duplicated femoral vein and its clinical significance

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    Anatomical variations in the femoral vein are of great clinical importance especially in cases of deep vein thrombosis (DVT). Knowledge of the variable anatomy of the femoral vein is important to minimise false-negative findings on ultrasound examination in patients with DVT and help to explain the ‘silent’ DVT.Furthermore, the presence of a duplicated femoral vein itself is associated with higher incidence of DVT. These venous anomalies are usually due to the truncular venous malformation. In the present study, while dissecting the right lower limb, we found a case of variation of the femoral vein. In this case, besides a duplicated femoral vein, we also noticed a 3rd interconnecting channel near the apex of the femoral triangle joining the two veins. This variation has not been reported previously by other authors. Considering its uniqueness and clinical importance,we decided to report this case

    Comparison of hyperemic efficacy between femoral and antecubital fossa vein adenosine infusion for fractional flow reserve assessment

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    Introduction: Intravenous infusion of adenosine via the femoral vein is commonly used to achieve maximum hyperemia for fractional flow reserve (FFR) assessment in the catheterization laboratory. In the era of transradial access for coronary interventions, obtaining additional venous access with sheath insertion in the groin is unpractical and may be associated with a higher risk of bleeding complications. In a vast majority of cases, patients scheduled for the catheterization laboratory are already equipped with peripheral vein access in antecubital fossa vein. However, only limited data exist to support non-central vein infusion of adenosine instead of the femoral vein for FFR assessment. Aim: To compare infusion of adenosine via a central versus a peripheral vein for the assessment of peak FFR. Material and methods: We enrolled 50 consecutive patients with 125 borderline coronary lesions that were assessed by FFR using adenosine femoral and antecubital vein infusion of 140 μg/kg/min. Results: Physiological severity assessed with femoral vein adenosine infusion at 140 μg/kg/min was mean 0.82 ±0.09, and with antecubital vein adenosine infusion at 140 μg/kg/min was 0.82 ±0.09. The mean time from initiation of adenosine infusion to maximal stable hyperemia was significantly shorter for 140 μg/kg/min femoral vein infusion as compared to antecubital vein infusion (49 ±19 s vs. 68 ±23 s; p < 0.001). There was a strong correlation between FFR values obtained from 140 μg/kg/min femoral and antecubital vein infusion (r = 0.99; p < 0.001). Conclusions: Antecubital vein adenosine infusion achieved FFR values are very similar to those obtained using femoral vein adenosine administration. However, time to maximal hyperemia is longer with infusion via the antecubital vein

    Venous velocity of the right femoral vein decreases in the right lateral decubitus position compared to the supine position: a cause of postoperative pulmonary embolism?

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    The right lateral decubitus position is a risk factor for postoperative pulmonary embolism. We examined postural changes of femoral vein velocity in order to elucidate the mechanism. Thirty patients scheduled for general thoracic surgery were enrolled in this study. The common femoral veins on both sides were examined by color-duplex ultrasound for venous caliber and velocity when the patients were in the right lateral, left lateral, and supine positions. The maximum diameters of the right femoral vein in the right lateral decubitus position and the left femoral vein in the left decubitus position were significantly larger than those in the other positions. The venous velocity of the right femoral vein in the right lateral decubitus position was significantly smaller than that in the supine position, while the velocity of the left femoral vein in the left lateral decubitus position was not significantly decreased. We speculate that the decreased venous velocity of the right femoral vein in the right lateral decubitus position could result in a deep venous thromboembolism in the right leg, making this position a possible risk factor for postoperative pulmonary embolism.</p

    Access via the femoral vein

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    Central venous access via the femoral vein (FV) is safe, relatively easy and very usual in infants and children undergoing cardiac surgery for congenital heart disease. It has a low insertion-related complication rate. It is therefore a good choice for short-term central venous lines and a preferred insertion site for less experienced staff. The maintenance-related complications of thrombus formation and infections are higher compared to the internal jugular and the subclavian venous access. Some of these complications are reduced by the use of heparin bonded catheters, routine use of antibiotics, and timely removal of these lines in patients with persistent signs of infection but without another focus being defined.peer-reviewe

    Erectile dysfunction due to ectopic penile vein

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    A total of 86/260 patients with erectile dysfunction had venous leakage as (joint) etiology. In 5 of 86 patients cavernosography showed pathologic cavernosal drainage only via an ectopic penile vein into the femoral vein. After ligation of this pathologic draining vessel, 4 of 5 patients regained spontaneous erectability. One patient with pathologic bulbocavernosus reflex latencies needed intracavernosal injection of vasoactive drugs for full rigidity

    Quantified duplex augmentation in healthy subjects and patients with venous disease: San Diego population study

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    AbstractObjective: This study was undertaken to determine the quantitative augmentation response in several veins examined in a cohort assembled to permit comparisons by sex, age, and ethnicity, under normal conditions and in the presence of obstruction, with and without trophic changes. Method: The common femoral vein, superficial femoral vein, sapheno-femoral junction, popliteal vein, sapheno-popliteal junction, and posterior tibial vein were studied with duplex ultrasonographic scanning. Augmentation response was elicited with use of an automated cuff inflator. Mean level of each response was analyzed according to patient sex, age, and ethnicity, each adjusted for the other two. Normal values were compared with those obtained from legs with venous obstructive disease, with or without signs of trophic changes. Results: Decreased augmentation response was noted only in the sapheno-femoral junction and sapheno-popliteal junction, and was smaller in women. Augmentation response was slightly increased in the oldest age group (>70 years) in the common femoral vein, superficial femoral vein, popliteal vein, and posterior tibial vein. The highest augmentation response was found in Asian subjects, in the common and superficial femoral veins and the sapheno-femoral and sapheno-popliteal junctions; and the smallest augmentation response was found in African American subjects, in these same veins and junctions. Differences in vein diameters may explain these findings, ie, smaller diameters in Asians and larger diameters in African Americans. Most important, compared with normal values, augmentation response was decreased in legs with venous obstructive disease only when trophic changes were present. Conclusion: Like quantification of reflux, quantitative evaluation of the augmentation response may help in diagnosis of venous obstructive disease when trophic changes are present. (J Vasc Surg 2003;37:1054-8.
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