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Sample records for superficial femoral arteries

  1. Percutaneous transluminal angioplasty of the superficial femoral artery by retrograde catheterization via the popliteal artery

    DEFF Research Database (Denmark)

    Tønnesen, K H; Sager, P; Karle, A;

    1988-01-01

    We report the results of 50 angioplasty procedures via the popliteal artery. A 3-year follow-up including control of blood pressures at ankle and toe levels show results comparable to reports in the literature. This new approach for angioplasty of the superficial femoral artery and eventually...

  2. New puncture needle (Seldinger technique) for easy antegrade catheterization of the superficial femoral artery

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    Saltzmann, J.; Probst, P.

    1987-02-01

    Mainly for anatomical reasons a guide-wire or a catheter has a tendency to turn into the deep femoral artery during antegrade catheterization of the lower limb. To overcome this problem a curved puncture needle has been designed which allows positioning of the guide-wire in an anterior direction. Antegrade catheterization of the superficial femoral artery was achieved in 25 patients without lengthy manipulations or complications. With this technique the rate of complications at antegrade catheterization will probably be reduced.

  3. Profunda Anchor Technique for Ipsilateral Antegrade Approach in Endovascular Treatment of Superficial Femoral Artery Ostial Occlusion

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    Pua, Uei, E-mail: druei@yahoo.com [Tan Tock Seng Hospital, Department of Diagnostic Radiology (Singapore)

    2015-04-15

    Endovascular treatment of the superficial femoral artery (SFA) is challenging in the presence of flush ostial occlusion. One of the main challenges is the availability of access sites for intervention. Contralateral retrograde femoral access followed by cross-over and antegrade intervention while commonly used, may not be feasible in cases of altered iliac anatomy (e.g. kissing iliac stents). Ipsilateral antegrade intervention using common femoral artery (CFA) access in these instances while possible is typically challenging due to inadequate working length of the CFA for interrogation of the SFA ostium, compounded by the lack of sheath stability. The “profunda anchor” technique uses a buddy wire in the profunda femoris artery (PFA) to stabilize the sheath and allow catheter manipulation for antegrade intervention at the level of the SFA ostium. The PFA is further used as a conduit for deployment of closure device to avoid interference with the treated SFA.

  4. Iliac Artery Stent Placement Relieves Claudication in Patients with Iliac and Superficial Femoral Artery Lesions

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    Ichihashi, Shigeo, E-mail: shigeoichihashi@yahoo.co.jp; Higashiura, Wataru; Itoh, Hirofumi; Sakaguchi, Shoji; Kichikawa, Kimihiko [Nara Medical University, Department of Radiology (Japan)

    2013-06-15

    Purpose. To evaluate the efficacy of iliac artery stent placement for relief of claudication in patients with both iliac and superficial femoral artery (SFA) lesions. Methods. Stent placement for only iliac artery occlusive disease was performed in 94 limbs (74 patients) with both iliac and SFA occlusive disease on the same limb. All procedures were performed because intermittent claudication did not improve after continuation of antiplatelet medication therapy and home-based exercise for 3 months. Rutherford classification was 2 in 20 limbs and 3 in 74 limbs. Patients with critical limb ischemia were excluded. Median duration of follow-up was 40 months. Primary patency rates of the iliac stent, clinical improvement rates, and risk factors for requiring additional SFA procedures were evaluated. Results. Primary patency rates of the iliac stent at 1, 3, 5, and 7 years were 97, 93, 79, and 79 %, respectively. The initial clinical improvement rate was 87 %. Continued clinical improvement rates at 1, 3, 5, and 7 years were 87, 81, 69, and 66 %, respectively. SFA Trans-Atlantic Inter-Society Consensus (TASC) II C/D lesion was a significant risk factor for requiring additional SFA procedures. Conclusion. Intermittent claudication was relieved by iliac stent placement in most patients with both iliac and SFA lesions. Thus, the indications for treatment of the SFA intended for claudicants should be evaluated after treatment of the iliac lesion.

  5. [Percutaneous treatment of a superficial femoral artery aneurysm using an intravascular stent-prosthesis].

    Science.gov (United States)

    Michel, C; Laffy, P Y; Leblanc, G; Riou, J Y; Chaloum, S; Maklouf, M; Le Guen, O

    1999-05-01

    One case of superficial femoral aneurysm treated percutaneously by endovascular stent graft (Passager Boston) is reported. The initial radiographic evaluation included arteriography and color doppler sonography which enable analysis of the flow path, the extent of the wall thrombus, the choice of stended graft size. The procedure of implantation was technically trouble free. The post-procedure 3D CT and arteriography demonstrated occlusion of the aneurysm and resaturation of normal flow path. The six and twelve month check confirmed the stability of the results locally and the integrity of run off vessels. In weakened and specially elderly patient percutaneous treatment of superficial femoral artery aneurysm can be carried out easily. The contribution of 3D CT is essential in follow up to ensure an optimal result and to detect any complication.

  6. Incidence, risk factors, treatment and prognosis of popliteal artery embolization in the superficial femoral artery interventions.

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    Weiwei Wu

    Full Text Available OBJECTIVE: Percutaneous transluminal angioplasty and stenting (PTA + stent has gained acceptance as a primary treatment modality for the superficial femoral artery (SFA diseases. Popliteal artery embolization (PAE is a severe complication in SFA interventions. The purpose of this study was to evaluate the incidence, risk factors, treatment and prognosis of PAE in primary SFA PTA + stent. METHODS: Chronic SFA arteriosclerosis cases that underwent primary PTA + stent were reviewed from a retrospectively maintained database. Runoff vessels were evaluated in all cases before and after the interventions for PAE detection. The primary patency, secondary patency and limb salvage rates were calculated using Kaplan-Meier analysis and compared using log-rank analysis. Cox multivariate regression was performed to evaluate predictors of patency and limb salvage rates. RESULTS: There were 436 lesions treated in 388 patients with 10 PAE events (2.3% in total. PAE rate was significantly higher in Transatlantic Inter-Society Consensus (TASC C/D group compared with TASC A/B group (OR = 8.91, P = .002, in chronic total occlusion (CTO lesions compared with stenotic lesions (P<.0001, and in group with history of cerebral ischemic stroke (OR = 6.11, P = .007. PAE rates were not significantly affected by age, sex, smoking, hypertension, diabetes, hyperlipidemia and runoff status. The binary logistic regression showed that only the TASC C/D was an independent predictor of PAE (P = .031. The 12-month and 24-month primary patency, secondary patency and limb salvage rates in PAE group showed no significant differences comparing with non-PAE group. CONCLUSIONS: PAE is a rare event in primary SFA PTA + stent. TASC C/D lesion, CTO and cerebral ischemic stroke history are risk factors for PAE. PAE is typically reversible by comprehensive techniques. If the popliteal flow is restored in time, PAE has no significant effect on long-term patency and limb

  7. [Use of autologous superficial femoral artery in surgery for aortic prosthesis infection].

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    da Gama, A Dinis; Rosa, António; Soares, Mário; Moura, Carlos

    2003-01-01

    The surgical management of the aortic prosthesis infection still remains an enormous challenge for the vascular surgeon and a critical issue for the patient's integrity and life. Several techniques for its management have been devised and employed, along the years, but none of them revealed itself as totally satisfactory. This stimulates the creation of new alternatives. We present the clinical case of an infected aortic prosthesis in a 41 year old man, complicated by duodenal and ureteral erosion, in whom the autologous superficial femoral artery was employed successfully in the treatment of this most demanding situation.

  8. French multicenter experience with the GORE TIGRIS Vascular Stent in superficial femoral and popliteal arteries.

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    Sibé, Maxime; Kaladji, Adrien; Boirat, Claire; Cardon, Alain; Chaufour, Xavier; Bossavy, Jean-Pierre; Saint-Lebes, Bertrand

    2017-05-01

    Preliminary results in small single-center studies after stenting with the GORE TIGRIS Vascular Stent (W. L. Gore & Associates, Flagstaff, Ariz) show promising short-term primary patency rates, but larger, multicenter studies are needed. This study therefore investigated the performance of the GORE TIGRIS Vascular Stent at three different centers in France in patients with symptomatic peripheral artery disease. This retrospective, single-arm, multicenter cohort study included 215 patients with peripheral artery disease (Rutherford-Becker category 2-6) who were treated with the GORE TIGRIS Vascular Stent, a dual-component stent consisting of a nitinol wire frame combined with a fluoropolymer-interconnecting structure. The efficacy end point was primary patency defined by freedom from binary restenosis as derived by duplex ultrasound imaging until 2 years after the intervention. Primary, secondary, and primary assisted patency rates at 3, 6, 12, 18, and 24 months were estimated by Kaplan-Meier analysis. The GORE TIGRIS Vascular Stent was used to successfully treat 239 lesions, of which 141 lesions were located in the superficial femoral artery and 98 in the popliteal artery. Patients were a mean age of 74 ± 12 years. Mean lesion length was 86.8 ± 44.7 mm. After 12 and 24 months, the overall primary patency rates were 81.5% and 67.2%, respectively, and primary assisted patency was 94.9% and 84.8%. Secondary patency was achieved in 99.1% at 24 months. Our multicenter experience with the GORE TIGRIS Vascular Stent demonstrates continued good results at 2 years for endovascular treatment of challenging obstructive superficial femoral artery and popliteal artery disease. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  9. Late Complication after Superficial Femoral Artery (SFA) Aneurysm: Stent-graft Expulsion Outside the Skin

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    Pecoraro, Felice, E-mail: felicepecoraro@libero.it; Sabatino, Ermanno R.; Dinoto, Ettore; Rosa, Giuliana La; Corte, Giuseppe; Bajardi, Guido [University of Palermo, Vascular Surgery Unit (Italy)

    2015-10-15

    A 78-year-old man presented with a 7-cm aneurysm in the left superficial femoral artery, which was considered unfit and anatomically unsuitable for conventional open surgery for multiple comorbidities. The patient was treated with stent-graft [Viabhan stent-graft (WL Gore and Associates, Flagstaff, AZ)]. Two years from stent-graft implantation, the patient presented a purulent secretion and a spontaneous external expulsion through a fistulous channel. No claudication symptoms or hemorrhagic signs were present. The pus and device cultures were positive for Staphylococcus aureus sensitive to piperacillin/tazobactam. Patient management consisted of fistula drainage, systemic antibiotic therapy, and daily wound dressing. At 1-month follow-up, the wound was closed. To our knowledge, this is the first case of this type of stent-graft complication presenting with external expulsion.

  10. The role of superficial femoral artery endoluminal bypass in long de novo lesions and in-stent restenosis.

    NARCIS (Netherlands)

    Doomernik, D.E.; Golchehr, B.; Lensvelt, M.M.A.; Reijnen, M.M.P.J.

    2012-01-01

    AIM: Results of endovascular treatment for long de novo lesions of the superficial femoral artery (SFA) are limited by in-stent restenosis (ISR). Polytetrafluoroethylene (PTFE) covered stents are developed to reduce the incidence of ISR. This study was conducted to summarize available data on the us

  11. Long-term results of open and endovascular revascularization of superficial femoral artery occlusive disease

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    Scali, Salvatore T.; Rzucidlo, Eva M.; Bjerke, Aja A.; Stone, David H.; Walsh, Daniel B.; Goodney, Philip P.; Chang, Catherine K.; Powell, Richard J.

    2017-01-01

    Background First-line treatment for patients with superficial femoral arterial (SFA) occlusive disease has yet to be determined. This study compared long-term outcomes between primary SFA stent placement and primary femoral-popliteal bypass. Periprocedural patient factors were examined to determine their effect on these results. Methods All femoral-popliteal bypasses and SFA interventions performed in consecutive patients with symptoms Rutherford 3 to 6 between 2001 and 2008 were reviewed. Time-dependent outcomes were analyzed using the Kaplan-Meier method and log-rank test. Cox proportional hazards were performed to determine predictors of graft patency. Multivariate analysis was completed to identify patient covariates most often associated with the primary therapy. Results A total of 152 limbs in 141 patients (66% male; mean age, 66 ± 22 years) underwent femoral-popliteal bypass, and 233 limbs in 204 patients (49% male; mean age, 70 ± 11 years) underwent SFA interventions. Four-year primary, primary-assisted, and secondary patency rates were 69%, 78%, and 83%, respectively, for bypass patients and 66%, 91%, and 95%, respectively, for SFA interventions. Six-year limb salvage was 80% for bypass vs 92% for stenting (P = .04). Critical limb ischemia (CLI) and renal insufficiency were predictors of bypass failure. Claudication was a predictor of success for SFA stenting. Three-year limb salvage rates for CLI patients undergoing surgery and SFA stenting were 83%. Amputation-free survival at 3 years for CLI patients was 55% for bypass and 59% for SFA interventions. Multivariate predictors (odds ratios and 95% confidence intervals) of covariates most frequently associated with first-line SFA stenting were TransAtlantic Inter-Society Consensus II A and B lesions (5.9 [3.4-9.1], P 70 years (2.1 [1.4-3.1], Ppatients were more likely to have nondiabetic status (5.6 [3.3-9.4], P patient-specific covariates, and anatomic lesion classification have significant association

  12. Acoustic hemostasis of porcine superficial femoral artery: Simulation and in-vivo experimental studies

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    Zeng, Xiaozheng; Mitchell, Stuart; Miller, Matthew; Barnes, Stephen; Hopple, Jerry; Kook, John; Moreau-Gobard, Romain; Hsu, Stephen; Ahiekpor-Dravi, Alexis; Crum, Lawrence A.; Eaton, John; Wong, Keith; Sekins, K. Michael

    2012-10-01

    In-vivo focused ultrasound studies were computationally simulated and conducted experimentally with the aim of occluding porcine superficial femoral arteries (SFA) via thermal coagulation. A multi-array HIFU applicator was used which electronically scanned multiple beam foci around the target point. The spatio-temporally averaged acoustic and temperature fields were simulated in a fluid dynamics and acousto-thermal finite element model with representative tissue fields, including muscle, vessel and blood. Simulations showed that with an acoustic power of 200W and a dose time of 60s, perivascular tissue reached 91°C; and yet blood reached a maximum 59°C, below the coagulation objective for this dose regime (75°C). Per simulations, acoustic-streaming induced velocity in blood reached 6.1cm/s. In in-vivo experiments, several arteries were treated. As simulated, thermal lesions were observed in muscle surrounding SFA in all cases. In dosing limited to 30 to 60 seconds, it required 257W to provide occlusion (one complete and one partial occlusion). Angiography and histology showed evidence of thrombogenesis and collagen shrinkage-based vessel constriction at these doses.

  13. PTA and stent placement distal to the superficial femoral artery; PTA und Stent distal der AFS

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    Rand, T.; Stadler, A.; Schoder, M.; Kettenbach, J. [Medizinische Universitaet Wien, Klinische Abteilung fuer Angiographie und Interventionelle Radiologie, Wien (Austria); Haumer, M. [Klinik fuer Innere Medizin II des Universitaetsklinikums Wien, Klinische Abteilung fuer Angiologie, Wien (Austria)

    2006-11-15

    Although angioplasty and stent applications in the iliac vessels and the superficial femoral artery have become routine procedures, their usefulness for the treatment of lesions of the popliteal artery and the lower leg arteries is still under discussion. For the popliteal artery, limitations are mainly due to the high mechanical stress in this area, causing high traction forces. Moreover, beyond the occlusive atherosclerotic changes, specific pathological entities such as aneurysms, emboli, entrapment syndromes, and cystic adventitial disease have to be differentiated. There is hope that the development of innovative stent designs with high flexibility might overcome the limitations. For lesions of the lower leg arteries treatment with percutaneous transluminal angioplasty (PTA) has become the method of choice. However, stent designs as used for cardiac interventions have been adapted for their application below the knee, and first encouraging results may help to justify their broad use in the future. Regarding PTA, innovative equipment and techniques for the treatment of arterial lesions below the knee include dedicated, long, and very flexible balloons, cutting balloon cryoplasty, and laser angioplasty. Regarding stents, bare metal stents, stents with passive or active coatings, and bioabsorbable stents have all been successfully used. (orig.) [German] Waehrend Angioplastie (PTA) und Stentbehandlung im Bereich der Beckengefaesse sich zu etablierten interventionellen Standardverfahren entwickelt haben, ist die endovaskulaere Behandlung von Laesionen der A. poplitea und auch der Unterschenkelgefaesse noch in Diskussion. Gruende hierfuer sind bei der A. poplitea v. a. die unguenstigen mechanischen Faktoren, die hohe Traktionskraefte am Gefaess wirken lassen und besonders die Gefaesspathologien, die neben der stenosierenden Atherosklerose auch andere spezifische Auspraegungen wie Aneurysmen, Embolien, Entrapmentsyndrome und die zystische Adventitianekrose umfassen

  14. In vivo imaging of superficial femoral artery (SFA) stents for deformation analysis

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    Ganguly, A.; Schneider, A.; Keck, B.; Bennett, N. R.; Fahrig, R.

    2008-03-01

    A high-resolution (198 μm) C-arm CT imaging system (Axiom Artis dTA, Siemens Medical Solutions, Forchheim, Germany) was optimized for imaging superficial femoral artery (SFA) stents in humans. The SFA is susceptible to the development of atherosclerotic lesions. These are typically treated with angioplasty and stent deployment. However, these stents can have a fracture rate as high as 35%. Fracture is usually accompanied by restenosis and reocclusion. The exact cause of breakage is unknown and is hypothesized to result from deforming forces due to hip and knee flexion. Imaging was performed with the leg placed in both straight and bent positions. Projection images obtained during 20 s scans with ~200° of rotation of the C-arm were back-projected to obtain 3D volumes. Using a semi-automatic software algorithm developed in-house, the stent centerlines were found and ellipses were fitted to the slice normals. Image quality was adequate for calculations in 11/13 subjects. Bending the leg was found to shorten the stents in 10/11 cases with the maximum change being 9% (12 mm in a 133 mm stent), and extend the stent in one case by 1.6%. The maximum eccentricity change was 36% with a bend angle of 72° in a case where the stent extended behind the knee.

  15. Drug-coated balloons are replacing the need for nitinol stents in the superficial femoral artery.

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    Kitrou, Panagiotis; Karnabatidis, Dimitrios; Katsanos, Konstantinos

    2016-08-01

    Amassed evidence from several randomized controlled trials and high quality meta-analyses clearly support the primary use of paclitaxel-coated balloons (PCB) in the superficial femoral artery over traditional plain balloon angioplasty or primary bare nitinol stenting with significantly lower vascular restenosis, less need for repeat procedures, improved quality of life and potential cost savings for the healthcare system. Stents may be reserved for bail-out in case of a suboptimal dilatation result, and for selected more complex lesions, or in case of critical limb ischemia in order to eliminate vessel recoil and maximize immediate hemodynamic gain. Debulking atherectomy remains unproven, but holds a lot of promise in particular in combination with PCBs, in order to improve compliance of the vessel wall by plaque removal, allow for a better angioplasty result and optimize drug transfer and bioavailability. The present overview summarizes and discusses current evidence about femoropopliteal PCB angioplasty compared to the historical standard of plain old balloon angioplasty and bare nitinol stents. Available evidence is appraised in the context of clinically meaningful results, relevant unresolved issues are highlighted, and future trends are discussed.

  16. Twelve months follow-up after retrograde recanalization of superficial femoral artery chronic total occlusion

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    Joanna Wojtasik-Bakalarz

    2017-03-01

    Full Text Available Introduction : Fifty percent of cases of peripheral artery disease are caused by chronic total occlusion (CTO of the superficial femoral artery (SFA. Ten–fifteen percent of percutaneous SFA recanalization procedures are unsuccessful. In those cases the retrograde technique can increase the success rate of the procedure, but the long-term follow-up of such procedures is still unknown. Aim : To assess the efficacy and clinical outcomes during long-term follow-up after retrograde recanalization of the SFA. Material and methods: We included patients after at least one unsuccessful percutaneous antegrade recanalization of the SFA. Patients were evaluated for the procedural and clinical follow-up of mean time 13.9 months. Results: The study included 17 patients (7 females, 10 males who underwent percutaneous retrograde recanalization of the SFA from June 2011 to June 2015. The mean age of patients was 63 ±7 years. Retrograde puncture of the distal SFA was successful in all cases. A retrograde procedure was performed immediately after antegrade failure in 4 (23.5% patients and after a previously failed attempt in 13 (76.5% patients. The procedure was successful in 15 (88.2% patients, and unsuccessful in 2 (11.8% patients. Periprocedural complications included 1 peripheral distal embolization (successfully treated with aspiration thrombectomy, 1 bleeding event from the puncture site and 7 puncture site hematomas. During follow-up the all-cause mortality rate was 5.8% (1 patient, non-cardiac death. The primary patency rate at 12 months was 88.2% and secondary patency 100%. Conclusions : The retrograde SFA puncture seems to be a safe and successful technique for CTO recanalization and is associated with a low rate of perioperative and long-term follow-up complications.

  17. Randomized Trial of the SMART Stent versus Balloon Angioplasty in Long Superficial Femoral Artery Lesions: The SUPER Study

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    Chalmers, Nicholas, E-mail: nicholas.chalmers@cmft.nhs.uk [Manchester Royal Infirmary, Department of Radiology (United Kingdom); Walker, Paul T. [James Cook University Hospital, Department of Radiology (United Kingdom); Belli, Anna-Maria [St. George' s Healthcare NHS Trust, Department of Radiology (United Kingdom); Thorpe, Anthony P. [Aberdeen Royal Infirmary, Department of Radiology (United Kingdom); Sidhu, Paul S. [King' s College Hospital, Department of Radiology (United Kingdom); Robinson, Graham [Hull Royal Infirmary, Department of Radiology (United Kingdom); Ransbeeck, Mariella van [Johnson and Johnson Medical NV/SA, Cordis (Belgium); Fearn, Steven A. [Johnson and Johnson Medical Ltd., Cordis (United Kingdom)

    2013-04-15

    To determine whether primary stenting reduces the rate of restenosis compared with balloon angioplasty alone in the endovascular treatment of long superficial femoral artery lesions; and to assess the effect of treatment on quality of life. A total of 150 patients with superior femoral artery occlusion or severe stenosis of 5-22 cm length from 17 UK centers were randomized to either primary stenting with the SMART stent or balloon angioplasty (i.e., percutaneous transluminal angioplasty, PTA). Bailout stent placement was permitted in case of inadequate result from PTA. The primary end point was restenosis measured by duplex ultrasound at 1 year. Quality-of-life assessments were performed by the EuroQol (EQ)-5D questionnaire. Mean lesion length was 123.0 mm in the stent group and 116.8 mm in the PTA group. A total of 140 (93.3 %) of 150 had total occlusions. At 12 months' follow-up, restenosis measured by Duplex ultrasound was not significantly different between the stent and PTA groups by intention-to-treat or as-treated analyses: 47.2 versus 43.5 % (p = 0.84) and 40.8 versus 46.7 % (p = 0.68), respectively. There were fewer target lesion revascularizations in patients randomized to stenting, but this did not reach statistical significance (12.5 vs. 20.8 %, p = 0.26). There was no difference in the rate of amputation. Patients in both groups reported improved quality of life. Primary stenting of long lesions in predominantly occluded superficial femoral arteries does not reduce the rate of binary restenosis compared with balloon angioplasty and bailout stenting. Both treatment strategies conferred a meaningful and sustained improvement to the quality of life of patients with severe superficial femoral artery disease.

  18. CryoPlasty therapy of the superficial femoral and popliteal arteries: a single center experience.

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    Samson, Russell H; Showalter, David P; Lepore, Michael R; Ames, Scott

    Long-term patency remains a significant hurdle in the minimally invasive treatment of arteriosclerosis in the superficial femoral and popliteal arteries. New technologies designed to address the sources of restenosis have recently been introduced. CryoPlasty therapy (Boston Scientific, Natick, Mass) is a new approach designed to significantly reduce injury, elastic recoil, stent implantation, neointimal hyperplasia, and constrictive remodeling. The technique combines the dilatation forces of percutaneous transluminal angioplasty with cold thermal energy applied to the plaque and vessel wall. The cumulative effect of limiting the sources of restenosis with CryoPlasty therapy was shown to demonstrate longer term patency in a prospective, multicenter, Investigational Device Exemption study of the PolarCath Peripheral Dilatation System. The CryoPlasty therapy experience of 1 center is reported, in which 47 lesions in 32 consecutive patients (34 procedures, 33 limbs) were treated. The technical success rate was 96%. There were no type 3 flow-limiting dissections, and only 4 (8.5%) lesions were stented. There were no unanticipated adverse events, specifically no thrombus, acute occlusions, distal embolizations, aneurysms, or groin complications. With an average follow-up of 12 months, only 5 lesions have recurred, 4 requiring re-intervention. The 12-month freedom from restenosis for lesions and limbs treated was 82.2% and 84.4%, respectively. These results are similar to the findings of the Investigational Device Exemption study and are encouraging. CryoPlasty therapy appears to be a viable endovascular therapeutic option to achieve longer term patency without compromising options for future interventions. The lack of early occlusions may be due to a low rate of spiral dissection that may be a particular benefit of this form of angioplasty.

  19. Feasibility and Safety of Vascular Closure Devices in an Antegrade Approach to Either the Common Femoral Artery or the Superficial Femoral Artery

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    Gutzeit, Andreas, E-mail: andreas.gutzeit@ksw.ch; Schie, Bram van, E-mail: Bram.vanschie@hotmail.com; Schoch, Eric, E-mail: eric.schoch@ksw.ch [Cantonal Hospital Winterthur, Department of Radiology (Switzerland); Hergan, Klaus, E-mail: k.hergan@salk.at [Paracelsus Medical University Salzburg, Department of Radiology (Austria); Graf, Nicole, E-mail: graf@biostatistics.ch; Binkert, Christoph A., E-mail: christoph.binkert@ksw.ch [Cantonal Hospital Winterthur, Department of Radiology (Switzerland)

    2012-10-15

    Introduction: The purpose of the present study was to analyze complications following antegrade puncture of the common femoral artery (CFA) and the superficial femoral artery (SFA) using vascular closure systems (VCS). Methods: A single-center, retrospective study was performed after obtaining approval from the institutional review board and informed consent from all patients. At our center, the CFA or SFA are used for arterial access. All patients were evaluated clinically on the same day. If there was any suspicion of an access site problem, Duplex ultrasound was performed. Results: Access location was the CFA in 50 patients and the SFA in 130 patients. The sheath size ranged from 4F to 10F. Two patients had to be excluded because of lack of follow-up. Successful hemostasis was achieved in 162 of 178 cases (91 %). The following complications were observed in 16 patients (8.9 %): 4 pseudoaneurysms (2.2 %), 11 hematomas (6.2 %), and 1 vascular occlusion (0.5 %). The two pseudoaneurysms healed spontaneously, in one case an ultrasound-guided thrombin injection was performed, and one aneurysm was compressed manually. No further medical therapy was needed for the hematomas. The one vascular occlusion was treated immediately with angioplasty using a contralateral approach. No significant difference was noted between the CFA and the SFA group with respect to complications (p = 1.000). Conclusions: The use of closure devices for an antegrade approach up to 10F is feasible and safe. No differences in low complication rates were observed between CFA and SFA.

  20. Critical evaluation of stents in the peripheral arterial disease of the superficial femoral artery – focus on the paclitaxel eluting stent

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    Litsky J

    2014-05-01

    Full Text Available Jason Litsky,1 Arijit Chanda,2 Erik Stilp,1 Alexandra Lansky,1 Carlos Mena11Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA; 2Section of Cardiology, Department of Internal Medicine, Bridgeport Hospital, Bridgeport, CT, USAAbstract: The endovascular management of obstructive disease of the superficial femoral artery (SFA is challenging due to unique anatomical and biomechanical forces. Obstructive lesions of the SFA make up the largest proportion of lesions leading to symptomatic peripheral arterial disease. Accordingly, endovascular treatment of SFA disease is becoming increasingly common and, in many cases, is the preferred initial therapy. The use of self-expanding nitinol stents have proven superior to percutaneous transluminal balloon angioplasty in the treatment of intermediate length SFA stenosis. However, achieving durable results, as well as attaining adequate therapy for long occlusions typically seen in clinical practice, remains problematic. Newer technologies, such as paclitaxel eluting stents, seem promising in improving outcomes.Keywords: Zilver PTX, self-expanding stent, atherosclerotic disease, superficial femoral artery

  1. The Use of ExoSeal Vascular Closure Device for Direct Antegrade Superficial Femoral Artery Puncture Site Hemostasis

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    Rimon, Uri, E-mail: rimonu@sheba.health.gov.il; Khaitovich, Boris, E-mail: borislena@012.net.il [Tel-Aviv University, Diagnostic and Interventional Imaging Department, Chaim Sheba Medical Center, Tel-Hashomer, Affiliated to the Sackler School of Medicine (Israel); Yakubovich, Dmitry, E-mail: Dmitry.Yakubovitch@sheba.health.gov.il [Tel-Aviv University, Vascular Surgery Department, Chaim Sheba Medical Center, Tel-Hashomer, Affiliated to the Sackler School of Medicine (Israel); Bensaid, Paul, E-mail: paulbensaid@hotmail.com; Golan, Gil, E-mail: gilgolan201@gmail.com [Tel-Aviv University, Diagnostic and Interventional Imaging Department, Chaim Sheba Medical Center, Tel-Hashomer, Affiliated to the Sackler School of Medicine (Israel); Silverberg, Daniel, E-mail: Daniel.Silverberg@sheba.health.gov.il [Tel-Aviv University, Vascular Surgery Department, Chaim Sheba Medical Center, Tel-Hashomer, Affiliated to the Sackler School of Medicine (Israel)

    2015-06-15

    PurposeThis study was designed to assess the efficacy and safety of the ExoSeal vascular closure device (VCD) to achieve hemostasis in antegrade access of the superficial femoral artery (SFA).MethodsWe retrospectively reviewed the outcome of ExoSeal VCD used for hemostasis in 110 accesses to the SFA in 93 patients between July 2011 and July 2013. All patients had patent proximal SFA based on computer tomography angiography or ultrasound duplex. Arterial calcifications at puncture site were graded using fluoroscopy. The SFA was accessed in an antegrade fashion with ultrasound or fluoroscopic guidance. In all patients, 5–7F vascular sheaths were used. The ExoSeal VCD was applied to achieve hemostasis at the end of the procedure. All patients were clinically examined and had ultrasound duplex exam for any puncture site complications during the 24 h postprocedure.ResultsIn all procedures, the ExoSeal was applied successfully. We did not encounter any device-related technical failure. There were four major complications in four patients (3.6 %): three pseudoaneurysms, which were treated with direct thrombin injection, and one hematoma, which necessitated transfusion of two blood units. All patients with complications were treated with anticoagulation preprocedure or received thrombolytic therapy.ConclusionsThe ExoSeal VCD can be safely used for antegrade puncture of the SFA, with a high procedural success rate (100 %) and a low rate of access site complications (3.6 %)

  2. Lower extremity computed tomography angiography can help predict technical success of endovascular revascularization in the superficial femoral and popliteal artery.

    Science.gov (United States)

    Itoga, Nathan K; Kim, Tanner; Sailer, Anna M; Fleischmann, Dominik; Mell, Matthew W

    2017-09-01

    Preprocedural computed tomography angiography (CTA) assists in evaluating vascular morphology and disease distribution and in treatment planning for patients with lower extremity peripheral artery disease (PAD). The aim of the study was to determine the predictive value of radiographic findings on CTA and technical success of endovascular revascularization of occlusions in the superficial femoral artery-popliteal (SFA-pop) region. Medical records and available imaging studies were reviewed for patients undergoing endovascular intervention for PAD between January 2013 and December 2015 at a single academic institution. Radiologists reviewed preoperative CTA scans of patients with occlusions in the SFA-pop region. Radiographic criteria previously used to evaluate chronic occlusions in the coronary arteries were used. Technical success, defined as restoration of inline flow through the SFA-pop region with technical failure (P = .014). Longer lengths of occlusion were also associated with technical failure (P = .042). Multiple occlusions (P = .55), negative remodeling (P = .69), vessel runoff (P = .56), and percentage of vessel calcification (P = .059) were not associated with failure. On multivariable analysis, 100% calcification remained the only significant predictor of technical failure (odds ratio, 9.0; 95% confidence interval, 1.8-45.8; P = .008). Analysis of preoperative CTA shows 100% calcification as the best predictor of technical failure of endovascular revascularization of occlusions in the SFA-pop region. Further studies are needed to determine the cost-effectiveness of obtaining preoperative CTA for lower extremity PAD. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  3. Invasive evaluation of plaque morphology of symptomatic superficial femoral artery stenoses using combined near-infrared spectroscopy and intravascular ultrasound.

    Science.gov (United States)

    Zacharias, Sibin K; Safian, Robert D; Madder, Ryan D; Hanson, Ivan D; Pica, Mark C; Smith, James L; Goldstein, James A; Abbas, Amr E

    2016-08-01

    The purpose of this study is to characterize the plaque morphology of severe stenoses in the superficial femoral artery (SFA) employing combined near-infrared spectroscopy and intravascular ultrasound (NIRS-IVUS). Atherosclerosis is the most common cause of symptomatic peripheral arterial disease. Plaque composition of SFA stenoses has been characterized as primarily fibrous or fibrocalcific by non-invasive and autopsy studies. NIRS has been validated to detect lipid-core plaque (LCP) in the coronary circulation. We imaged severe SFA stenoses with NIRS-IVUS prior to revascularization in 31 patients (46 stenoses) with Rutherford claudication ⩾ class 3. Angiographic parameters included lesion location and stenosis severity. IVUS parameters included plaque burden and presence of calcium. NIRS images were analyzed for LCP and maximum lipid-core burden index in a 4-mm length of artery (maxLCBI4mm). By angiography, 38 (82.6%) lesions were calcified and 9 (19.6%) were chronic total occlusions. Baseline stenosis severity and lesion length were 86.0 ± 11.0% and 36.5 ± 46.5 mm, respectively. NIRS-IVUS identified calcium in 45 (97.8%) lesions and LCP in 17 (37.0%) lesions. MaxLCBI4mm was 433 ± 244. All lesions with LCP also contained calcium; there were no non-calcified lesions with LCP. In conclusion, this is the first study of combined NIRS-IVUS in patients with PAD. NIRS-IVUS demonstrates that nearly all patients with symptomatic severe SFA disease have fibrocalcific plaque, and one-third of such lesions contain LCP. These findings contrast with those in patients with acute coronary syndromes, and may have implications regarding the pathophysiology of atherosclerosis in different vascular beds.

  4. Successful Endovascular Repair of an Iatrogenic Perforation of the Superficial Femoral Artery Using Self-Expanding Nitinol Supera Stents in a Patient with Acute Thromboembolic Limb Ischemia

    Directory of Open Access Journals (Sweden)

    Tom Eisele

    2016-01-01

    Full Text Available The treatment of acute thromboembolic limb ischemia includes well-established surgical thrombectomy procedures and, in recent times, also percutaneous rotational thrombectomy using Straub Rotarex® system. This modality not only enables efficient treatment of such thrombotic occlusion but also in rare cases may imply the risk of perforation of the occluded artery. Herein, we report the case of a perforation of the superficial femoral artery (SFA in an elderly female patient with thromboembolic limb ischemia. The perforation was successfully treated by implantation of self-expanding nitinol Supera stents and without the need for implantation of a stent graft.

  5. Twelve-month experience with the GORE® TIGRIS® Vascular Stent in the superficial femoral and popliteal arteries.

    Science.gov (United States)

    Piorkowski, M; Freitas, B; Steiner, S; Botsios, S; Bausback, Y; Scheinert, D; Schmidt, A

    2015-02-01

    The aim of this paper was to report the continued mid-term follow-up of the first patients world-wide treated with the GORE(®) TIGRIS(®) Vascular Stent, a dual component stent consisting of a nitinol wire frame combined with a fluoropolymer-interconnecting structure. From December 2011 until November 2012, 32 consecutive patients (20 men, mean age 72.8 years) with 40 atherosclerotic femoropopliteal lesions (5% occlusions) underwent angioplasty and implantation of a GORE(®) TIGRIS(®) Vascular Stent. The patients were scheduled for follow-up at 3, 6 and 12 months after stent implantation for duplex ultrasound and assessment of Rutherford-Becker class (RBC) and Ankle-Brachial Index (ABI). Here we report the completed 6-month follow-up and, for the first time, a 12-month follow-up. The median follow-up was 418 days. During the 12-month follow-up 4 patients died. Restenosis or reocclusion of the stent in this time period was observed in 5 lesions (12.5%), resulting in a cumulative primary patency rate of 85.5±6.0%. The ABI increased pre-interventionally from 0.65±0.18 to 0.91±0.18 (PGORE(®) TIGRIS(®) Vascular Stent showed promising results with high 12-month primary patency rates after femoropopliteal endovascular interventions. These first clinical data are very promising compared to other stent concepts in the superficial femoral and popliteal artery.

  6. Drug-eluting stents in superficial femoral artery treatment: could they be the standard of care?

    Science.gov (United States)

    Bosiers, Marc; Deloose, Koen; Callaert, Joren; Peeters, Patrick; Bosiers, Michel

    2016-12-01

    Endovascular techniques have improved markedly over the past several decades. Plain old balloon angioplasty can only reach patencies around 40% after 1 year. Scaffolding stents have resulted in improved short-term results but encountered limitations for longer-term durability. With the introduction of drug-eluting technologies the process of intimal hyperplasia might be slowed, resulting in improved long-term patency results. At first, limus-eluting technologies were not able to transfer the enthusiasm from the coronaries to the infrainguinal vascular bed. However, the newer generation paclitaxel-eluting technologies perform significantly better in femoropopliteal arteries than their non-eluting or non-coated counterparts. The results of a prospective randomized trial comparing DES versus DCB is eagerly awaited. For the moment there seems, based on the meta-analysis, no difference between the two treatment modalities. Although, we need to keep in mind that DCB perform worse in long calcified lesions.

  7. The association of lesion eccentricity with plaque morphology and components in the superficial femoral artery: a high-spatial-resolution, multi-contrast weighted CMR study

    Directory of Open Access Journals (Sweden)

    Zhao Xihai

    2010-07-01

    Full Text Available Abstract Background Atherosclerotic plaque morphology and components are predictors of subsequent cardiovascular events. However, associations of plaque eccentricity with plaque morphology and plaque composition are unclear. This study investigated associations of plaque eccentricity with plaque components and morphology in the proximal superficial femoral artery using cardiovascular magnetic resonance (CMR. Methods Twenty-eight subjects with an ankle-brachial index less than 1.00 were examined with 1.5T high-spatial-resolution, multi-contrast weighted CMR. One hundred and eighty diseased locations of the proximal superficial femoral artery (about 40 mm were analyzed. The eccentric lesion was defined as [(Maximum wall thickness- Minimum wall thickness/Maximum wall thickness] ≥ 0.5. The arterial morphology and plaque components were measured using semi-automatic image analysis software. Results One hundred and fifteen locations were identified as eccentric lesions and sixty-five as concentric lesions. The eccentric lesions had larger wall but similar lumen areas, larger mean and maximum wall thicknesses, and more calcification and lipid rich necrotic core, compared to concentric lesions. For lesions with the same lumen area, the degree of eccentricity was associated with an increased wall area. Eccentricity (dichotomous as eccentric or concentric was independently correlated with the prevalence of calcification (odds ratio 3.78, 95% CI 1.47-9.70 after adjustment for atherosclerotic risk factors and wall area. Conclusions Plaque eccentricity is associated with preserved lumen size and advanced plaque features such as larger plaque burden, more lipid content, and increased calcification in the superficial femoral artery.

  8. Loss of bifurcation patency after cross-over stenting of ostial lesions in superficial femoral artery: possible causes, prevention and reintervention

    Institute of Scientific and Technical Information of China (English)

    Jiang Junhao; Chen Bin; Dong Zhihui; Shi Yun; Li Weimiao; Yue Jianing

    2014-01-01

    Background Crossover stenting across the origin of the profunda femoral artery (PFA) and occasionally into the common femoral artery (CFA) is commonly used after suboptimal balloon angioplasty of ostial occlusive lesions of the superficial femoral artery (SFA) involving the bifurcation.Late stent occlusion at the bifurcation is not rare and results in severe lower extremity ischemia.Therefore,we tried to assess its possible causes,prevention and reintervention.Methods Using a prospectively maintained single-center database,12-month femoral bifurcation patency was retrospectively compared and lesion and procedural predictors of stent occlusion were determined among 63 patients (64 lesions) who between July 2011 and February 2013 underwent crossover (36 non-jailed and 15 jailed SFA,and 12 distal and 1 complete CFA) stenting of de novo ostial SFA lesions.Results Twelve-month overall patency rate at the femoral bifurcation was 88%,with no significant difference between jailed-ostial SFA (80%) and distal CFA (67%) stenting (P=0.731),and significant differences between either and non-jailed ostial stenting (100%,P=0.035 and 0.002).When PFA ostium was jailed by the stent,patients with preexisting CFA or PFA lesions had a 12-month bifurcation patency rate of 20%,significantly lower than those with simple ostial SFA lesions (83%,P=0.015).Stent induced intimal hyperplasia caused bifurcation occlusion in 6 surgical reintervention cases.Conclusions In crossover stenting of ostial lesions in SFA,bifurcation patency loss was significantly higher in distal CFA and jailed ostial SFA stenting than non-jailed ostial SFA stenting.Preexisting CFA or PFA lesion is a significant risk factor for bifurcation patency loss when PFA ostium is jailed by crossover stenting.

  9. Randomized control study of the outback LTD reentry catheter versus manual reentry for the treatment of chronic total occlusions in the superficial femoral artery.

    Science.gov (United States)

    Gandini, Roberto; Fabiano, Sebastiano; Spano, Sergio; Volpi, Tommaso; Morosetti, Daniele; Chiaravalloti, Antonio; Nano, Giovanni; Simonetti, Giovanni

    2013-09-01

    To assess the efficacy and safety of the Outback device in patients with a chronic total occlusion (CTO) of the superficial femoral artery and evaluate its impact on fluoroscopy and procedural times. From October 2006 to March 2007, 52 patients affected by TASC II-D superficial femoral artery CTO were treated with subintimal recanalization. Clinical indications for endovascular recanalization were: claudication, tissue loss, and at rest leg pain with critical limb ischemia. In 26 patients the manual reentry technique was used and in 26 the OUTBACK(®) LTD Re-Entry Catheter was used. Total procedure time, fluoroscopy time and precision in targeting the expected reentry site have been compared. Technical success was achieved in all cases (100%). In group 2, the planned in-target re-entry was achieved in 11/26 cases (42.3%). The procedure was performed with a traditional antegrade approach in 23/26 (88.4%) cases and in three cases (11.6%) a combined antegrade/retrograde approach was necessary. In group 1, the in-target re-entry was achieved in 26/26 cases (100%). In group 2, the mean procedural time was 55.4 ± 14.2 min with a mean fluoroscopy time 39.6 ± 13.9 min compared to 36.0 ± 9.4 min and 29.8 ± 8.9 min, respectively, of group 1 (P < 0.0001). In our experience, the use of this device is very useful for the revascularization of chronic femoral occlusions, even calcific, in which an accurate re-entry cannot be achieved with the conventional subintimal technique. In these cases, the Outback device grants high technical success rates and a significant reduction of procedural and fluoroscopy times. Copyright © 2013 Wiley Periodicals, Inc.

  10. Randomized trial of Legflow® paclitaxel eluting balloon and stenting versus standard percutaneous transluminal angioplasty and stenting for the treatment of intermediate and long lesions of the superficial femoral artery (RAPID trial): Study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    A. Karimi; S.W. de Boer (Sanne W.); D.A.F. Van Den Heuvel; B. Fioole (Bram); D. Vroegindeweij (Dammis); J.M.M. Heyligers (Jan); P.N.M. Lohle (Paul N.M.); O.E. Elgersma (Otto E.); R.P.T. Nolthenius (Rudolf ); J.A. Vos (Jan Albert); J.-P.P.M. de Vries (Jean-Paul)

    2013-01-01

    textabstractBackground: Restenosis after percutaneous transluminal angioplasty (PTA) of the superficial femoral artery (SFA) may occur in 45% of patients at 2 years follow-up. Paclitaxel-coated balloons have been found to reduce neointimal hyperplasia, and thus reduce restenosis. Recently, the Legfl

  11. High Residual Collagen-Induced Platelet Reactivity Predicts Development of Restenosis in the Superficial Femoral Artery After Percutaneous Transluminal Angioplasty in Claudicant Patients

    Energy Technology Data Exchange (ETDEWEB)

    Gary, Thomas, E-mail: thomas.gary@medunigraz.at [Medical University of Graz, Division of Angiology, Department of Internal Medicine (Austria); Prüller, Florian, E-mail: florian.prueller@klinikum-graz.at; Raggam, Reinhard, E-mail: reinhard.raggam@klinikum-graz.at [Medical University of Graz, Clinical Institute of Medical and Chemical Laboratory Diagnostics (Austria); Mahla, Elisabeth, E-mail: elisabeth.mahla@medunigraz.at [Medical University of Graz, Department of Anesthesiology and Intensive Care Medicine (Austria); Eller, Philipp, E-mail: philipp.eller@medunigraz.at; Hafner, Franz, E-mail: franz.hafner@klinikum-graz.at; Brodmann, Marianne, E-mail: marianne.brodmann@medunigraz.at [Medical University of Graz, Division of Angiology, Department of Internal Medicine (Austria)

    2016-02-15

    PurposeAlthough platelet reactivity is routinely inhibited with aspirin after percutaneous angioplasty (PTA) in peripheral arteries, the restenosis rate in the superficial femoral artery (SFA) is high. Interaction of activated platelets and the endothelium in the region of intervention could be one reason for this as collagen in the subendothelium activates platelets.Materials and MethodsA prospective study evaluating on-site platelet reactivity during PTA and its influence on the development of restenosis with a total of 30 patients scheduled for PTA of the SFA. Arterial blood was taken from the PTA site after SFA; platelet function was evaluated with light transmission aggregometry. After 3, 6, 12, and 24 months, duplex sonography was performed and the restenosis rate evaluated.ResultsEight out of 30 patients developed a hemodynamically relevant restenosis (>50 % lumen narrowing) in the PTA region during the 24-month follow-up period. High residual collagen-induced platelet reactivity defined as AUC >30 was a significant predictor for the development of restenosis [adjusted odds ratio 11.8 (9.4, 14.2); P = .04].ConclusionsHigh residual collagen-induced platelet reactivity at the interventional site predicts development of restenosis after PTA of the SFA. Platelet function testing may be useful for identifying patients at risk.

  12. Cutting-Balloon Angioplasty Versus Balloon Angioplasty as Treatment for Short Atherosclerotic Lesions in the Superficial Femoral Artery: Randomized Controlled Trial

    Energy Technology Data Exchange (ETDEWEB)

    Poncyljusz, Wojciech, E-mail: wponcyl@poczta.onet.pl; Falkowski, Aleksander, E-mail: bakhis@hot.pl [Pomeranian Medical University, Department of Interventional Radiology (Poland); Safranow, Krzysztof, E-mail: chrissaf@mp.pl; Rac, Monika, E-mail: carmon@pum.edu.pl [Pomeranian Medical University, Department of Biochemistry and Medical Chemistry (Poland); Zawierucha, Dariusz, E-mail: dariusz13@yahoo.com [Interventional Radiology, Sacred Heart Medical Center, River Bend (United States)

    2013-12-15

    Purpose: To evaluate the treatments of a short-segment atherosclerotic stenosis in the superficial femoral arteries with the cutting balloon angioplasty (CBA) versus conventional balloon angioplasty [percutaneous transluminal angioplasty (PTA)] in a randomized controlled trial. Material and Methods: The study group comprised 60 patients (33 men, 27 women; average age 64 years) with a short ({<=}5 cm) focal SFA de novo atherosclerotic stenosis associated with a history of intermittent claudication or rest pain. The primary end point of this study was the rate of binary restenosis in the treated segment 12 months after the intervention. All patients were evenly randomized to either the PTA or CBA treatment arms. Follow-up angiograms and ankle-brachial index (ABI) measurements were performed after 12 months. The evaluation of the restenosis rates and factors influencing its occurrence were calculated by logistic regression analysis. Results: In the intention-to-treat analysis, restenosis rates after 2-month follow-up were 9 of 30 (30 %) in the PTA group and 4 of 30 (13 %) in the CBA group (p = 0.117). In the actual treatment analysis, after exclusion of patients who required nitinol stent placement for a suboptimal result after angioplasty alone (5 patients in the PTA group and none in the CBA group), restenosis rates were 9 of 25 (36 %) and 4 of 30 (13 %), respectively (p = 0.049). In the intention-to-treat analysis there were also significant differences in ABI values between the PTA and CBA groups at 0.77 {+-} 0.11 versus 0.82 {+-} 0.12, respectively (p = 0.039), at 12 months. Conclusion: Based on the presented results of the trial, CBA seems to be a safer and more effective than PTA for treatment of short atherosclerotic lesions in the superior femoral artery.

  13. p21-Activated Kinase 4 Promotes Intimal Hyperplasia and Vascular Smooth Muscle Cells Proliferation during Superficial Femoral Artery Restenosis after Angioplasty

    Directory of Open Access Journals (Sweden)

    Liangxi Yuan

    2017-01-01

    Full Text Available The aim of this study is to explore the function of p21-activated kinase 4 (PAK4 in intimal hyperplasia (IH and vascular smooth muscle cells (VSMCs proliferation. We choose vascular samples from patients undergoing angioplasty in superficial femoral artery (SFA as the experimental group and vascular samples from donors without clinical SFA restenosis as the control group, respectively. We draw from the results that both levels of mRNA and protein of PAK4 in the experimental group increased dramatically compared with the control group. IH arose from angioplasty of SFA. Moreover, overexpression of PAK4 dramatically contributed to cell proliferation of VSMCs and promoted cell cycle progression from G0/G1 phase (71.12±0.69% versus 58.77±0.77%, P<0.001 into S phase (23.99±0.21% versus 31.35±0.33%, P<0.001. Besides, PAK4 downregulated the level of p21 and enhanced the activity of Akt as well. And we conclude that PAK4 acts as a regulator of cell cycle progression of VSMC by mediating Akt signaling and controlling p21 levels, which further modulate IH and VSMCs’ proliferation.

  14. Combined stent placement and high dose PGE1 drip infusion for chronic occlusion of the superficial femoral artery as a modality to salvage chronic critical limb ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Ikushima, Ichiro [Department of Radiology, Miyakonojo Medical Association Hospital, 5822-3 Oiwadacho, Miyakonojo 885-0062 (Japan)], E-mail: iku-i@fk.enjoy.ne.jp; Hirai, Toshinori [Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University (Japan); Ishii, Akihiko [Department of Radiology, Miyakonojo Medical Association Hospital, 5822-3 Oiwadacho, Miyakonojo 885-0062 (Japan); Yamashita, Yasuyuki [Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University (Japan)

    2008-04-15

    Purpose: To assess the initial effect, short-term patency, and limb salvage rates of combined stent placement and high-dose prostaglandin E-1 (PGE1) drip infusion for chronic occlusion of the superficial femoral artery (SFA). Materials and methods: A total of 15 arteriosclerotic occlusive lesions of the SFA were treated in 11 consecutive patients (mean age: 78.4 years old). All cases were of category 4 or 5, based on the criteria of the Society of Vascular Surgery and Intermittent Society for Cardiovascular Surgery (SVC/ISCVS). In all cases a self-expandable stainless steel stent was implanted. PGE1 treatment was started 3-5 days before stent placement and continued for 7-10 days after the intervention. The technical success, limb salvage outcomes, patency rates, and complications were examined. Results: In all cases, the technical success rate of the procedure was 100%. After stent implantation, the clinical status of all cases was improved by at least +2, and major amputation was not required in any cases. The 12-month primary, secondary patency rates, and limb salvage rate were 57%, 100%, and 100%, respectively. Conclusion: Combined stent placement and high-dose PGE1 drip infusion is a treatment of choice for salvaging the lower limb of a patient with chronic critical ischemia.

  15. Use of the Stingray Re-Entry System in Two Complex Cases of Occluded Superficial Femoral Arteries

    OpenAIRE

    Galbraith, Erin M.; Marc Del Rosario; Khusrow Niazi

    2011-01-01

    Totally occluded infrainguinal arterial disease presents formidable challenges to endovascular revascularization. A variety of devices have been made available to make the crossing of these lesions more amenable to endovascular techniques. We discuss the novel use of a device that has been developed for crossing occluded coronary arteries, the Stingray Re-Entry System.

  16. Use of the Stingray Re-Entry System in Two Complex Cases of Occluded Superficial Femoral Arteries

    Directory of Open Access Journals (Sweden)

    Erin M. Galbraith

    2011-01-01

    Full Text Available Totally occluded infrainguinal arterial disease presents formidable challenges to endovascular revascularization. A variety of devices have been made available to make the crossing of these lesions more amenable to endovascular techniques. We discuss the novel use of a device that has been developed for crossing occluded coronary arteries, the Stingray Re-Entry System.

  17. Recanalização da artéria femoral superficial com stents Zilver: técnica padronizada e análise retrospectiva de 3 anos Superficial femoral artery recanalization with Zilver stents: standard technique and 3-year retrospective analysis

    Directory of Open Access Journals (Sweden)

    Marcelo Ferreira

    2006-12-01

    Full Text Available OBJETIVOS: Descrever a técnica de recanalização endovascular da artéria femoral superficial e fazer uma análise retrospectiva dos 3 primeiros anos da técnica. MÉTODOS: Análise retrospectiva dos pacientes tratados entre 2001 e 2004, visando obter as taxas de perviedade das recanalizações. A amostra considerada neste estudo consta de 79 artérias femorais superficiais recanalizadas em 61 pacientes, nos quais foram utilizados exclusivamente a técnica descrita e o mesmo modelo de stent de nitinol auto-expansível (Zilver, COOK. RESULTADOS: Dos 61 pacientes, 8% possuíam isquemia crítica de membro inferior e 92% apresentavam claudicação incapacitante refratária ao tratamento clínico. A melhora clínica foi observada e referida pelos pacientes numa relação direta à perviedade das recanalizações. A análise estatística demonstrou taxas acumuladas de perviedade primária assistida de 98, 91 e 84% em 12, 24 e 37 meses, respectivamente. As taxas de perviedade, entendida como fluxo continuado nas recanalizações, foram de 96, 93 e 93% em 12, 24 e 37 meses, respectivamente. CONCLUSÕES: Consideramos a técnica da recanalização da artéria femoral superficial um método ao mesmo tempo pouco invasivo, com reduzidas complicações e de consideráveis taxas de sucesso anatômico e perviedade, que, em conjunto, são capazes de proporcionar satisfação e qualidade de vida aos pacientes portadores de doença arterial obstrutiva periférica.OBJECTIVES: To describe the endovascular recanalization technique of the superficial femoral artery and perform a 3-year retrospective analysis of the technique. METHODS: Retrospective analysis of the patients treated between 2001 and 2004, with the aim of obtaining the patency rates of the recanalizations. The sample consisted of 79 recanalized superficial femoral arteries in 61 patients, exclusively using the described technique and the same nitinol self-expanding stent model (Zilver, COOK. RESULTS

  18. Management of femoral artery pseudoaneurysm due to addictive drug injection

    Institute of Scientific and Technical Information of China (English)

    李建文; 王三明; 陈小东

    2004-01-01

    Objective: To study surgical management for patients with femoral pseudoaneurysm resulting from addictive druginjection.Methods: Clinical data of 34 patients with femoral pseudoaneurysm resulting from addictive drug injection were retrospectively reviewed.Results: Thirteen patients underwent bypass graft ( end to side) of external iliac artery and superficial femoral artery using expanded polytetrafluoroethylene (ePTFE).Three patients who had an autogenous saphenous vein graft in situs, one of whom was then performed an ePTFE graft when rupture and bleeding occurred at the anastomotic site. Color Doppler image showed patent grafted blood vessels in all the patients after operation. Eighteen patients had their femoral arteries ligated. Limbs of all the 34 patients were saved.Conclusions: Ligating femoral artery is an effective way to treat femoral artery pseudoaneurysm if autogenous saphenous vein graft or artificial vessel graft is notapplicable.

  19. First clinical experience with the Innova versus the Protege EverFlex self-expanding bare metal stents in superficial femoral artery occlusions.

    Science.gov (United States)

    Gabrielli, Roberto; Rosati, Maria Sofia; Chiappa, Roberto; Millarelli, Massimiliano; Marcuccio, Luigi; Siani, Andrea; Caselli, Giovanni

    2015-03-01

    To evaluate outcomes of superficial femoral artery (SFA) stenting with Boston Scientific Innova stent system (Boston Scientific Corporation Place, Natick, Massachusetts, United States) compared with ev3 Protege stent system (Endovascular, Inc., Plymouth, Minnesota, United States) in terms of safety and effectiveness and to identify factors predictive of restenosis. From March 2012 to January 2013, 71 patients with SFA TASC (Trans Atlantic Inter-Societal Consensus)-II B and C occlusive lesions were treated by percutaneous transluminal angioplasty with stenting (30 patients in the Innova group and 41 cases in the Protege group) and were evaluated by retrospective observational data analysis. Chi-square tests for categorical data and time to event provided two-sided p values with a level of significance at 0.05 and 95% confidence intervals (CIs). Survival curves for primary patency were plotted using the Kaplan-Meier method. Univariate analysis for diabetes, hypercholesterolemia, smoking, hypertension, and critical limb ischemia was performed according to the Cox proportional hazards model. The mean follow-up was 14 months (range 1-18 months). The occlusive lesions treated were ≤15 cm in length. The 12-month primary patency rate was significantly higher in the Protege group (81.5%; 31/38) than the Innova group (43.3%; 13/30; hazard ratio [HR] 3.0; 95% CI: 1.38-6.8; p = 0.005. The secondary patency was similar to the primary comparison data and showed a significant advantage for the Protege stent (HR 2.9; 95% CI: 1.21-6.99; p = 0.01). Univariate analysis demonstrated that diabetes and smoking were significantly related to patency failure in both groups. SFA stenting is generally a safe procedure, but the effectiveness and patency rates are significantly lower for Innova than Protege. Furthermore, preoperative diabetes and smoking continue to be associated with low primary patency rate. These preliminary data suggest that Innova stent is not the treatment of choice

  20. Salvage of critical limb ischemia with the "trellis reserve'' of subintimal superficial femoral-popliteal artery occlusion: a new modality in managing critical limb ischemia--a case report.

    LENUS (Irish Health Repository)

    Sultan, Sherif

    2005-01-01

    Subintimal angioplasty is a safe, effective, but nondurable procedure in treating long superficial femoral artery occlusions in patients with severe lower limb ischemia. The authors report a case of acute thrombosis that presented 16 weeks after subintimal angioplasty. The ;;Trellis\\'\\' percutaneous thrombolytic infusion system permitted a controlled site-specific infusion of recombinant tissue-type plasminogen activator (rtPA). The unique design of the ;;Trellis\\'\\' allowed complete aspiration of thrombus and avoiding regional and systemic thrombolytic side effects. The ;;Trellis\\'\\' system is effective in percutaneous management of thrombotic lesions; however, intimal dissection may need to be addressed.

  1. Drug-Eluting Nitinol Stent Treatment of the Superficial Femoral Artery and Above-the-Knee Popliteal Artery (The Zilver PTX Single-Arm Clinical Study): A Comparison Between Diabetic and Nondiabetic Patients

    Energy Technology Data Exchange (ETDEWEB)

    Fanelli, Fabrizio, E-mail: fabrizio.fanelli@uniroma1.it [Sapienza University of Rome, Vascular and Interventional Radiology Unit, Department of Radiological Sciences (Italy); Primo, Massimiliano Di [Hopital Europeen Georges Pompidou, University Paris Descartes (France); Boatta, Emanuele [Sapienza University of Rome, Vascular and Interventional Radiology Unit, Department of Radiological Sciences (Italy); Johnston, Krystal, E-mail: kjohnston@medinst.com [MED Institute, Inc (United States); Sapoval, Marc, E-mail: marc.sapoval2@egp.aphp.fr [Hopital Europeen Georges Pompidou, University Paris Descartes (France)

    2013-10-15

    Purpose: To describe the 1-year results of drug-eluting nitinol stent placement in the femoropopliteal artery of diabetic and nondiabetic patients. Materials and Methods: All patients enrolled in this prospective, multicenter study underwent paclitaxel-eluting stent placement for de novo or restenotic lesions of the superficial femoral and/or popliteal artery. Baseline and follow-up walking impairment questionnaire (WIQ) scores, Rutherford classifications, and ankle-brachial index (ABI) measurements were obtained. Follow-up was completed at 1, 6, and 12 months. Results: There were 285 diabetic patients and 502 nondiabetic patients treated. There were no significant differences in mean lesion length or lesion calcification between patient groups. Procedural success in both treatment groups was >97 %. There were no significant differences between diabetic and nondiabetic groups in Kaplan-Meier estimates of patency, event-free survival (EFS), or freedom from target lesion revascularization (TLR) at 6 and 12 months. Both groups experienced a significant increase in ABI and WIQ values after treatment, and these improvements were sustained to 12-month follow-up; however, nondiabetic patients had significantly greater 6- and 12-month WIQ scores compared with diabetic patients. Based on covariate analysis, the only factors shown to be significant and to negatively influence patency were longer lesion length (p = 0.009), higher Rutherford classification (p = 0.02), and lack of hypertension (p = 0.02); diabetic status was not found to be a significant factor. Conclusion: Diabetic and nondiabetic patients had similar estimates of primary patency, EFS, and freedom from TLR; however, diabetic patients showed less improvement in WIQ scores compared with nondiabetic patients.

  2. 切割球囊扩张在股浅动脉长段闭塞治疗中的作用%Angioplasty with cutting balloon in patient with long segmental obstruction of superficial femoral artery

    Institute of Scientific and Technical Information of China (English)

    王爱林; 徐恒; 刘军; 韩圣辉

    2012-01-01

    Objective To compare the technical success rate and midterm results of cutting balloon angioplasty (CBA) to conventional balloon angioplasty (BA) for treatment of long segmental obstruction of the superficial femoral artery. Methods Between March 2009 and May 2010, 33 patients with long segmental obstruction of the superficial femoral artery treated with conventional angioplasty underwent cutting angioplasty. Follow-up consisted clinical examination and computed tomographic angiography at interval of one year. Results After conventional angioplasty there were still severe stenoses in the treated segments of the superficial femoral artery among the 33 selected patients. The stenosis rate decreased from 60% -95% (average 78%) post-conventional angioplasty to 15% -45% (average 36%) after cutting balloon angioplasty. Three patients complicated minor vessel dissection without other major complication. The one year patency of the cutting balloon angioplasty was 66% , which is better than the patency of the conventional balloon angioplasty ( 37% ) . Conclusion Cutting balloon angioplasty provides better vessel patency additional to balloon angioplasty in the treatment of the long segmental obstruction of the superficial femoral artery.%目的 分析评价在常规球囊扩张基础上加用切割球囊治疗股浅动脉长段闭塞的治疗效果和中期通畅率.方法 应用了切割球囊扩张治疗33例股浅动脉长段闭塞患者,导丝通过闭塞段后,首先应用常规球囊进行扩张后,进行动脉造影,对常规球囊扩张后仍有明显狭窄部位进行切割球囊扩张,再次动脉造影评价切割球囊扩张效果.术后对经过治疗的24例患者进行1年的中期随访,并与前期完成的24例单纯常规球囊扩张的1年通畅率进行比较,总结分析两者的中期通畅率、再狭窄的病变特点.结果 在股浅动脉长段闭塞部位进行常规球囊扩张后,均存在不同部位的短段重度狭窄,狭窄部位位于

  3. [Femoral artery pseudoaneurysms encountered in orthopedics and traumatology].

    Science.gov (United States)

    Raherinantenaina, F; Rajaonanahary, T M A; Rakoto Ratsimba, H N

    2015-12-01

    Most published articles regarding orthopedic- and trauma-related femoral artery pseudoaneurysms (FAPs) are case reports in English. Reported cases are often associated with a literature review but actually provide little robust data. We wanted to summarize the current knowledge on diagnostic and therapeutic features of these FAPs. A new case of superficial FAP is described followed by a review of the literature. A bibliographic search was performed online (PubMed, ScinceDirect) from 1964 to 2015 using the descriptors "traumatic femoral pseudoaneurysm, orthopedic surgery, osteochondroma". A total of 64 cases of FAPs was analyzed. There were 50 men with an average age of 40.72±26.45 years old. The most common clinical presentation was painful swelling (34%). Arteriography was the commonest radiological investigation used (63%). The main etiologies were orthopedic injuries (47%), surgery of the upper thigh (30%) and femoral osteochondromas (23%). Arterial injuries included superficial femoral (47%) and profunda femoris artery (50%). The treatment was open surgery (56%) or endovascular repair (36%). Deep femoral artery and its branches were embolized (47%) or ligated (38%). Endovascular stenting was performed in 30% of posttraumatic FAPs. All FAPs relating to osteochondromas were repaired surgically. Postoperative courses were uneventful in 95% of patients. Endovascular embolization is preferred in management of postsurgical FAPs which have usually involved the deep femoral artery. Endovascular stenting graft may be proposed for posttraumatic FAPs, for which the superficial femoral trunk is the most often involved vessel. Surgical repair should be performed when endovascular stenting graft is not feasible. Surgical repair is mandatory for all FAPs secondary to traumatic exostoses. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  4. Femoral artery recanalisation with percutaneous angioplasty and segmentally enclosed plasminogen activator

    DEFF Research Database (Denmark)

    Jørgensen, B; Tønnesen, K H; Bülow, J;

    1989-01-01

    To establish whether re-occlusion of the femoral artery could be prevented, in 6 consecutive patients undergoing percutaneous transluminal angioplasty (PTA) for superficial femoral artery occlusion the recanalised segment was isolated, with a 7-French double-balloon catheter. 5 mg recombined human...

  5. Viabahn腔内人工血管治疗股浅动脉狭窄闭塞性病变%Primary effectiveness of the GORE (R) Viabahn endoprosthesis in stenosed or obliterated superficial femoral artery

    Institute of Scientific and Technical Information of China (English)

    郝良玉; 庄百溪; 张童; 马鲁波; 于春利; 杨淼; 石波

    2014-01-01

    Objective To observe the primary clinical results of Gore (R) Viabahn endoprosthesis for atherosclerotic stenosis or occlusion in superficial femoral artery (SFA).Methods From March 2013 to November 2013,45 consecutive patients (54 limbs) who had ischemic symptom due to stenosis or occlusion of superficial femoral artery were treated by endovascular deployment of Gore (R) Viabahn endoprosthesis.We observed patency rate,improvement of Rutherford classification and ankle-brachial index,limb salvage rate and survival rate after 1,3 and 6 months.Results 43 patients (52 limbs)were followed-up,among which 32 patients(38 limbs)belonged to TASC Ⅱ type C or type D lesion.The mean (± SD) length of treated segment in 52 limbs was(19 ±4)cm.The rate of postoperative patency on duplex ultrasonography:one month,3 months and 6 months were 96.15% (50 limbs),92.31% (48 limbs)and 90.38% (47 limbs) ; Ankle-brachial index increased from(0.32 ±0.20)to(0.68 ±0.18) (t =3.180,P < 0.005) after 6 months ; at 6 months limb salvage rate was 96.08 percent (49 limbs),and survival rate was 97.67% (42 patients).Conclusions Implantation of Gore (R) Viabahn endoprosthesis in atherosclerotic stenotic or occluded superficial femoral artery safely achieves a definite primary clinical effectiveness.%目的 总结分析股浅动脉粥样硬化狭窄闭塞病变置入Viabahn腔内人工血管的初期疗效.方法 回顾性分析2013年3-11月收治的因症状性股浅动脉硬化狭窄或闭塞而置入Viabahn腔内人工血管45例患者(54条肢体)临床资料,观察术后l、3、6个月的通畅率、临床分级改善程度、踝肱比变化、保肢率及生存率.结果 最终完成43例患者(52条肢体)的随访数据收集,其中TASCⅡC型及D型病变32例(38条肢体).52条肢体治疗段长度为13.3~32.5cm,平均长度为(19±4) cm;血管超声随访通畅率:术后1、3、6个月分别为96.15%(50条肢体)、92.31%(48条肢体)和90.38%(47条肢

  6. Popliteal artery local technique in superficial femoral artery antegrade subintimal recanalization%腘动脉局域超选技术用于股浅动脉内膜下顺行开通

    Institute of Scientific and Technical Information of China (English)

    裴轶飞; 刘广钦; 包俊敏

    2012-01-01

    Objective To evaluate popliteal artery local technique in superficial femoral artery antegrade subintimal recanalization.Methods From January 2009 to Dec 2011,550 limbs in 476 TASC (Trans-Atlantic Inter-Society Consensus) Ⅱ C/D cases underwent endo-therapy at our department.The success rate、operation time、symptom progress and follow up were analyzed retrospectively.Results In the 550 limbs,62 limbs received popliteal artery local technique directly.There was 9 technical failures.Procedures succeeded in 53 limbs(85.5% ).The average operation time was (69 ±24) min,(1.8 ±0.6) stents were used and the main covered length was ( 33 ± 6) cm.Symptoms of 46 limbs was improved and unchanged in 6,amputation needed to be done in one limb.One year follow up accomplished for 39 limb.The 6 and 12 months patence rate was 87.1% and 69.2%.For 488 limbs using traditional approach 378 achieved anti-grade recanalization,the average operation time was ( 89 ± 30) min,average (2.1 ± 0.6) stents were used and the main covered length is (31 ± 13) cm.Symptom in 300 limbs improved.The half and one year patence rate in 292 limbs was 92.1% and 61.0%.Conclusions The popliteal artery local technique is as effective as with traditional approach and is time saving.%目的 研究腘动脉局域超选法在完成股浅动脉顺向内膜下开通中的作用.方法 2009年1月至2011年12月对467例患者(550条肢体)行腔内治疗,病变均为泛大西洋协作组(Trans-Atlantic Inter-Society Consensus,TASC)定义的ⅡC/D级股腘动脉闭塞.统计其中直接应用腘动脉局域超选技术和传统真腔超选方法的62条肢体,观察其手术成功率、手术时间、症状改善和随访情况.结果 在550条肢体中,62条肢体直接应用了腘动脉局域超选技术,其中9条肢体未能顺向返回真腔操作.53条肢体(85.5%)完成手术,平均手术时间(69 ±24) min,平均支架应用数(1.8±0.6)枚,平均覆盖长度(33 ±6) cm.46条肢体(86.8

  7. Superficial Temporal Artery Pseudoaneurysm: A Case Report

    Science.gov (United States)

    Younus, Syed Muneeb; Imran, Muhammad; Qazi, Rabia

    2015-01-01

    Pseudoaneurysms of the superficial temporal artery are an uncommon vascular lesion of the external carotid system and most often the result of blunt head trauma. The frequency of pseudoaneurysms of the superficial temporal artery developing after craniotomy is exceedingly low and only a few cases have been reported. We present a case of pseudoaneurysm of this type in a 45-year-old male who underwent craniotomy for excision of meningioma. One month postoperatively, the craniotomy flap exhibited an enormous diffuse pulsate swelling. The suspected diagnosis of pseudoaneurysm arising from superficial temporal artery was confirmed on angiography. Surgical excision was done and no recurrences of the tumor or aneurysm were noted on subsequent follow up. PMID:26501064

  8. Correlation Study of Ankle Brachial Index,Superficial Femoral Artery Intima-media Thickness and the Coronary Heart Disease%踝臂指数及股浅动脉内中-膜厚度与冠心病相关性研究

    Institute of Scientific and Technical Information of China (English)

    应卫华; 李浙成; 胡智星; 童跃锋

    2012-01-01

    目的 探讨踝臂指数(ABI)及股浅动脉内-中膜厚度(IMT)与冠心病相关性.方法 对132例入选对象行冠状动脉造影检查、超声测定股浅动脉IMT及用全自动动脉硬化检测仪检测ABI,并调查年龄、性别、吸烟、血压、家族史、体质指数(BMI)等.用冠状动脉病变血管的数量和GAS积分评价冠脉病变的程度,分析、对比不同病变程度下股浅动脉IMT及ABI.结果 冠心病组股浅动脉IMT明显大于非冠心病组,冠心病组ABI明显小于非冠心病组,差异存在统计学意义,P值均小于0.05;股浅动脉IMT随着冠状动脉病变程度的加重而增加,但冠心病各组间比较无显著差异;ABI随着冠状动脉病变程度的加重而降低,且ABI值在各组间比较,P<0.05,差异具有统计学意义.结论 股浅动脉IMT及ABI与冠心病显著相关.对于冠心病患者,对比股浅动脉IMT与ABI,ABI是更能间接反映冠状动脉病变严重程度的良好指标.%Objective To discuss correlation of the superficial femoral artery intima-media thickness (IMT),ankle brachial index (ABI) and coronary heart disease. Methods .132 cases of hospitalized patients were selected to performed coronary artery angiography and ultrasound measurement of superficial femoral artery intima-media thickness (IMT) and automatic arteriosclerosis detection instrument of ankle brachial index (ABI),and the age, sex,smoking, blood pressure,family history,body weight index (BMI) etc were investigated. With coronary artery lesion volume and GAS integral evaluation of coronary lesion extent,the different extent of lesions of the superficial femoral artery intima-media thickness and ankle brachial index (ABI) were analysed. Results The superficial femoral artery intima-media thickness of coronary heart disease group was significantly greater than that of non-CHD group; ankle brachial index (ABI)was significantly lower than that of non-CHD group,there were statistically significant difference

  9. Reference values for local arterial stiffness. Part B : femoral artery

    NARCIS (Netherlands)

    Bossuyt, Jelle; Engelen, Lian; Ferreira, Isabel; Stehouwer, Coen D; Boutouyrie, Pierre; Laurent, Stéphane; Segers, Patrick; Reesink, Koen; Van Bortel, Luc M

    2015-01-01

    OBJECTIVE: Carotid-femoral pulse wave velocity (PWV) is considered the gold standard measure of arterial stiffness, representing mainly aortic stiffness. As compared with the elastic carotid and aorta, the more muscular femoral artery may be differently associated with cardiovascular risk factors (C

  10. Airport and superficial femoral artery obstruction due to a wandering coronary stent: the possibility of airport detection of modern implant metals.

    Science.gov (United States)

    Teijink, J A W; van Herwaarden, J A; van den Berg, J C; Overtoom, T C; Moll, F L

    2004-06-01

    In the treatment of coronary artery disease, peripheral loss of a coronary stent is an unusual complication. We present the case of a patient who suggested that his right leg claudication was caused by a slipped coronary stent 2 years previously. The patient was convinced about this unusual finding based on an airport security check. Examination proved him to be right. However, the ability to detect an object using eddy currents is dependent on the object's permeability and its conductivity. Ferrous (iron) content is not the critical factor. Modern implant materials and processing techniques result in implants that are difficult to magnetize i.e. their permeability is very low. In addition their conductivity is very low. This enables modern implants to escape detection at airports. For this reason the event at the airport, as described by our patient, is considered coincidental.

  11. Recanalization of superficial femoral artery occlusions with Outback LTD catheter%股浅动脉闭塞性病变中Outback LTD导管的应用分析

    Institute of Scientific and Technical Information of China (English)

    张宏鹏; 郭伟; 刘小平; 尹太; 贾鑫; 王立军; 熊江; 马晓辉

    2012-01-01

    目的 探讨股浅动脉慢性完全闭塞性病变(CTO)中应用Outback LTD导管内膜下成形术治疗技术的近中期结果.方法 2010年1月至2011年5月,30例股浅动脉CTO的35条肢体应用Outback LTD导管进行治疗.其中男性20例,女性10例,平均年龄68岁.重度间歇性跛行10条肢体(Rutherford 3级,28.6%),静息痛13条肢体(Rutherford 4级,37.1%),小面积溃疡12条肢体(Rutherford 5级,34.3%).所有患者术中应用常规的导管和导丝技术无法顺行从内膜下返回真腔.统计技术成功率、相关并发症及操作时间.随访中计算支架通畅率和治疗结果.结果 平均病变长度为(210±15)mm,操作技术成功率为97.1% (34/35),无操作相关的并发症发生.平均随访时间(7.2±0.3)个月.随访3、6、12个月支架一期通畅率分别为90.9%、84.8%和50.6%.重度缺血病变中,3条肢体行截趾术,1条行膝关节以下的截肢术.结论 Outback LTD导管在股浅动脉CTO内膜下成形术中能够安全、有效地辅助导丝返回真腔,缩短射线暴露时间,提高技术成功率.%Objective To evaluate immediate- and median-term outcomes from subintimal recanalization of superficial femoral arteries (SFA) chronic total occlusions (CTO) with the Outback LTD catheter.Methods From January 2010 to May 2011,35 legs in 30 patients with CTO of the SFA and proximal popliteal artery were treated by Outback LTD catheter.There were 20 male and 10 female patients.The mean age of the patients was 68 years. Clinical presentation was severe intermittent claudication (Rutherford category 3,10/35,28.6% ),rest pain (Rutherford category 4,13/35,37.1% ),and minor ulceration (Rutherford category 5,12/35,34.3% ).In all cases,the true lumen could not be entered by using standard antegrade catheter and guide wire techniques.Technical success,complications,procedure times,clinical outcomes and cumulative patency rates in follow-up were evaluated.Results Median lesion length was

  12. Inadvertent femoral artery "stripping": surgical management.

    Science.gov (United States)

    Liddicoat, J E; Bekassy, S M; Daniell, M B; De Bakey, M E

    1975-02-01

    Following "vein stripping" for varicosities, two patients were referred to our service for evaluation of arterial insufficiency of the lower extremities. Both patients had had surgical interruption of the femoral arterial system which required reconstruction. This paper emphasizes the importance of understanding surgical anatomy and presents the techniques of successful surgical management of both cases.

  13. Acute Iliac and Femoral Arterial Thrombosis Secondary to Total Hip Arthroplasty

    Directory of Open Access Journals (Sweden)

    Nikola Fatic

    2014-12-01

    Full Text Available In the presented case report, we evaluated the mechanism of the external iliac, the common femoral and the superficial femoral arterial thrombosis secondary to total hip arthroplasty. A 75-year-old female sufferd from 5.5 cm shorter left lower limb and same sade coxarthritis. Next day after arthroplasty and eqalisation of the lower limbs, an acute ishemia of the treated leg was presented. Multyscan CT angiography revealed the presence of the external iliac, the common femoral and the superficial femoral arterial thrombosis. From the best of our knowledge, it seems to be the only case of this arterial segment thrombosis after total hip arthroplasty and equalistaion of the lower limbs reported.

  14. Drug-eluting technologies in femoral artery lesions.

    Science.gov (United States)

    Deloose, K; Lauwers, K; Callaert, J; Maene, L; Keirse, K; Verbist, J; Peeters, P; Bosiers, M

    2013-04-01

    The treatment of femoropopliteal lesions has known an important evolution in the last years. An important limitation of current endovascular therapy remains the occurrence of restenosis. In order to minimize restenosis rates, drug eluting technologies are evolving. The use of drug-eluting stents (DES) in coronary arteries shows beneficial results, leading to investigation of DES in femoropopliteal arteries. In this article, we give an overview of current available data on treatment with drug eluting technologies in the superficial femoral artery (SFA). This paper summarizes also the current available data of the use of drug-coated balloons (DCB) in the femoropopliteal tract. Currently, no data are available on the use of DCB in long lesions. A drug eluting bioresorbable scaffold seems to be very promising in coronary arteries. The transfer to the peripheral area is nowadays ongoing. Which technique and device for which lesion and patient requires further investigation to build up a real evidence based SFA treatment strategy.

  15. Continuous blood gas monitoring in femoral arteries

    Science.gov (United States)

    Schlain, Les A.; Spar, Steven M.; Dellinger, Bart

    1995-05-01

    Continuous intra-arterial blood gas monitoring is a potentially valuable tool in the surgical and intensive care arenas. Patient oxygenation and acid base status can change rapidly and without warning. The ability to monitor pHa, PaCO2 and PaO2 in arterial blood will be a major medical advance for the anesthesiologist and intensivist. Intra-arterial blood gas sensors are typically placed in radial arteries. In certain patient populations accurate monitoring is not possible in radial arteries due to arterial environmental factors such as hypotension, vasoconstriction and atherosclerotic disease. These same factors can make radial cannulation difficult resulting in traumatic catheter insertion, thereby further compromising flow conditions. In situations where radial artery flow is expected to be compromised, selecting a large vessel for sensor placement is desirable. We report an initial feasibility study of our blood gas monitoring system using the femoral artery as the sensing site. Clinical results are presented as well as potential advantages and disadvantages associated with monitoring in the femoral artery.

  16. The anatomy of the superficial external pudendal artery: a quantitative study Anatomia da artéria pudenda superficial externa: estudo quantitativo

    Directory of Open Access Journals (Sweden)

    Osvaldir Lanzoni La Falce

    2006-10-01

    Full Text Available The importance of the superficial external pudendal artery in cases of lower limb obstructive arteriopathies has been established, and a perfect knowledge of its anatomy is desirable for the creation of successful flaps involving it. However, little information is available on the morphometry of this artery. PURPOSE: In this study, we conducted a quantitative investigation of the superficial external pudendal artery as the basis for skin grafts. METHOD: Twenty-five right and left sides of the inguinal region of male cadavers were dissected. After retracting the skin at the inguinal region, the femoral vessels and the sapheno-femoral junction were exposed. The following aspects were then analyzed: 1 the presence of the superficial external pudendal artery, 2 the place of origin of the superficial external pudendal artery and the common trunk, 3 the duplication of the superficial external pudendal artery, 4 the distance from the superficial external pudendal artery or the common trunk to the inguinal ligament, and 5 the diameter of the superficial external pudendal artery. RESULTS: The results were the following: 1 superficial external pudendal arteries were found in 46 of 50 sides (92%; 2 they originated from the femoral artery in 45 cases and from the deep femoral artery in only 1 case; 3 the arteries were found duplicated in 21 cases (46%, as a common trunk in 11 cases (24%, and as a single artery in 14 cases (30%; 4 the distance from the superficial external pudendal artery to the inguinal ligament ranged from 0.8 cm to 8.5 cm; from the common trunk, it ranged from 3.5 cm to 6.7 cm; 5 the diameter of the superficial external pudendal artery ranged from 1.2 mm to 3.8 mm; and 6 the diameter of the common trunk ranged from 1.35 mm to 5.15 mm. CONCLUSION: The results show that the superficial external pudendal artery generally originates from the femoral artery. It was found as a common trunk, duplicated, or as a single artery. There was a great

  17. Traumatic aneurysm of superficial temporal artery. CT demonstration

    Energy Technology Data Exchange (ETDEWEB)

    Sharma, A.; Tyagi, G.; Sahai, A.; Baijal, S.S. (G.B. Pant Hospital and M.A. Medical Coll., New Delhi (India). Dept. of Neurosurgery G.B. Pant Hospital and M.A. Medical Coll., New Delhi (India). Dept. of Radiology)

    1991-12-01

    A case of traumatic pseudo-aneurysm of the superficial temporal artery documented on Computed tomography (CT) and angiography is described in a 55-year-old female, who was treated by surgical excision. Computed tomographic appearance of this lesion is illustrated. This represents, to our knowledge, the first CT demonstration of traumatic aneurysm of superficial temporal artery within a large subgaleal haematoma. (orig.).

  18. Surgical treatment of noniatrogenic trauma of the femoral arteries.

    Science.gov (United States)

    Wolosker, N; Guadêncio, A; Kuzniec, S; Rosoky, R A; Kalume, C; Neves, C A; Aun, R; Langer, B

    1996-01-01

    Trauma to the femoral arteries corresponds to 30 percent of all arterial traumas. The authors reviewed 74 patients with noniatrogenic trauma of the femoral arteries treated from January 1991 to December 1993. Ages ranged from 11 to 50 years, with a mean of 24. Seventy-one patients were male and three female. Fifty-two patients (70.2 percent) were white, 20 (27 percent) were black and two (2.8 percent) were Asian. Trauma due to firearms had the highest incidence, with 61 cases (82.4 percent). Absence of pulse was the most frequent clinical symptom (62.5 percent). Severe ischemia, with risk of loss of limb, was found in 66.2 percent of the cases. The superficial femoral artery was impaired in 77 percent of the cases. A preoperative arteriography was performed on only five patients, victims of multiple penetrating trauma or an asymptomatic penetrating wound along a vessel passage. In six cases, arterial and venous ligature was the chosen procedure. In three cases, a primary arterial anantomosis was performed. Simple arterriorraphy was feasible in one patient. In 64 of the patients, a venous graft was undertaken using a segment of the inverted great saphenous vein withdrawn from the other lower limb. Fasciotomoy was used in 32 patients (43.2 percent), all of whom exhibited pasting of the lower limb muscles at admission. One patient died during the immediate postoperative period as the result of multiple organ failure caused by polytraumatism. Preservation of the limb was attained in 72 patients (97.3 percent) Severe, previously-incurred ischemia was responsible for the only two amputations, aggravated by an exceedingly long delay between the time of injury and surgery. One of these patients, in addition to severe ischemia, had extensive injuries to the soft tissues. We conclude that trauma of the femoral arteries, attended while the limb still maintains its vitality, has a positive clinical outcome with a high rate of limb preservation. Mortality usually results from

  19. Surgical treatment of noniatrogenic trauma of the femoral arteries

    Directory of Open Access Journals (Sweden)

    Nelson Wolosker

    Full Text Available Trauma to the femoral arteries corresponds to 30 percent of all arterial traumas. The authors reviewed 74 patients with noniatrogenic trauma of the femoral arteries treated from January 1991 to December 1993. Ages ranged from 11 to 50 years, with a mean of 24. Seventy-one patients were male and three female. Fifty-two patients (70.2 percent were white, 20 (27 percent were black and two (2.8 percent were Asian. Trauma due to firearms had the highest incidence, with 61 cases (82.4 percent. Absence of pulse was the most frequent clinical symptom (62.5 percent. Severe ischemia, with risk of loss of limb, was found in 66.2 percent of the cases. The superficial femoral artery was impaired in 77 percent of the cases. A preoperative arteriography was performed on only five patients, victims of multiple penetrating trauma or an asymptomatic penetrating wound along a vessel passage. In six cases, arterial and venous ligature was the chosen procedure. In three cases, a primary arterial anantomosis was performed. Simple arterriorraphy was feasible in one patient. In 64 of the patients, a venous graft was undertaken using a segment of the inverted great saphenous vein withdrawn from the other lower limb. Fasciotomoy was used in 32 patients (43.2 percent, all of whom exhibited pasting of the lower limb muscles at admission. One patient died during the immediate postoperative period as the result of multiple organ failure caused by polytraumatism. Preservation of the limb was attained in 72 patients (97.3 percent Severe, previously-incurred ischemia was responsible for the only two amputations, aggravated by an exceedingly long delay between the time of injury and surgery. One of these patients, in addition to severe ischemia, had extensive injuries to the soft tissues. We conclude that trauma of the femoral arteries, attended while the limb still maintains its vitality, has a positive clinical outcome with a high rate of limb preservation. Mortality usually

  20. Interventional therapy for atherosclerotic occlusive disease of the superficial femoral artery%介入治疗股浅动脉硬化闭塞19例分析

    Institute of Scientific and Technical Information of China (English)

    祝慧鹏; 周艺琳; 冯翔; 李鸣; 包俊敏; 景在平

    2009-01-01

    Objective To explore the methods and mid-term results of interventional therapy for atherosclerotic occlusive disease of the superficial femoral artery(SFA).Methods From January 2005 to August 2008,Nineteen cases with 22 diseased lower limbs were admitted.According to Fontaine stage system,there were 6 stage Ⅱb limbs(moderate to severe intermittent claudication),8 stage Ⅲ limbs(rest pain),and 8 stage Ⅳ limbs(6 with ulcer and 2 with gangrene).The mean lesion length was 8.8 cm(5~13 cm).On the basis of the TransAtlantic Inter-Society Consensus(TASC)femoropopliteal classification,the lesions were classified as type B in 4 limbs,type C in 17,and D in 1.Follow up examinations with color duplex ultrasound and/or arteriography were carried out to determine the patency.The improvement of clinical symptoms after operation was analyzed.Results 17 limbs were revascularization successfully,2 limbs were turned to bypass operation,3 limbs were judged untreatable.The technical success rate is 77.3%,and the clinical improvement of symptoms was achieved in 100% of the 17 limbs on which the procedure was successful.The 17 limbs were followed up for a mean of 12.5 months(range 3-33 months).One patient died of cardia infarction one month postoperatively.SFA occlusion happened in 4 limbs.At one year postoperatively,the patency rate was 75%(13/17)after primary operation.Conclusions Primary endovascular treatment of SFA occlusion diseases is a safe,minimally invasive,and effective method.%目的 探讨股浅动脉硬化闭塞介入治疗的方法和疗效.方法 回顾性分析2005年1月至2008年8月介入治疗的19例(22条下肢)股浅动脉硬化闭塞症患者的临床资料.其中Fontaine Ⅱb期(中、重度间歇跛行)6条,Ⅲ期(静息痛)8条,Ⅳ期(组织缺损)8条(其中足部溃疡6条,足趾坏疽2条).股浅动脉病变的平均长度8.8 cm(5.0~13 cm).病变TASC分型B型4条,C型17条,D型1条.通过彩色血管超声和(或)动脉造影观察病变段动脉

  1. Osteonecrosis of Femoral Head Occurred after Stent Placement of Femoral Artery

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    Akiyoshi Shimatani

    2014-01-01

    Full Text Available We present a case of osteonecrosis of femoral head (ONFH that occurred after stent angiography of femoral artery for the treatment of arteriosclerosis obliterans (ASO of left inferior limb in a 76-year-old woman. No case of late collapse of femoral head as a complication of endovascular procedure such as stent placement has been previously documented. We considered that ONFH occurred after detaining stent at a junction of left deep femoral artery for the treatment of the ischemia of left lateral and medial femoral circumflex artery.

  2. Location of femoral artery puncture site and the risk of postcatheterization pseudoaneurysm formation.

    Science.gov (United States)

    Gabriel, Marcin; Pawlaczyk, Katarzyna; Waliszewski, Krzysztof; Krasiński, Zbigniew; Majewski, Wacław

    2007-08-21

    Iatrogenic causes constitute increasingly frequent sources of pseudoaneurysms due to endovascular interventions. However, till now, all analyses focused on evaluating different risk factors contributing to the development of pseudoaneurysm, overlooking the issue of localization of femoral puncture. The aim of this study was to assess the influence of position of femoral artery puncture on the risk of pseudoaneurysm formation. 116 patients were evaluated for the site of catheter insertion into femoral arteries. Another group of 273 patients, suspected of vascular complications after endovascular procedures, were diagnosed with pseudoaneurysms which were analyzed for the location of arterial wall disruption. Puncture sites of groin arteries, i.e. EIA (2.7%), CFA (77.5%), SFA and DFA (19.8%), correlated with pseudoaneurysm location reaching 7.6% (EIA), 54.3% (CFA) and 38.1% (SFA, DFA). Type of procedure influenced these values. Duplex ultrasound mapping of CFA before the endovascular intervention eliminated discrepancies between the incidence of pseudoaneurysm formation and the frequency of arterial puncture in the selected vascular segments. Pseudoaneurysms formed in 4.5% of patients undergoing traditional palpation-guided vessel cannulation and in 2.6% of patients after ultrasound-guided puncture of the femoral artery. Upon further analysis, we concluded that the likelihood of the development of pseudoaneurysm depends on the artery punctured in the groin. This risk increases dramatically for external iliac artery, superficial and deep femoral arteries. A simple means of prevention of this dangerous complication of femoral artery puncture is duplex ultrasound mapping of the groin arteries.

  3. MORPHOLOGICAL STUDY OF MEDIAL CIRCUMFLEX FEMORAL ARTERY IN HUMAN CADAVERS

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    Brijesh R. Aghera

    2014-10-01

    Full Text Available Background: Medial circumflex femoral artery is an important branch of Profunda femoris artery. It is an important artery in supplying blood to the head and neck of the femur, the adductor muscles and form anastomosis around head of femur. So study of variation of medial circumflex femoral artery great value for surgeon and orthopaedic surgeries. Materials and Methods: The present study includes 102 lower limbs of adult formalin fixed human cadavers used for the routine dissection procedure for under graduate and post graduate students in the department of Anatomy, M.R. Medical College, KBN Medical college and H K E Homeopathic College, Gulbarga (India during 2011-2014.The study was done by dissection method as per Cunningham’s manual of practical Anatomy. Result: In present study, we found that 25 extremities (25.49% medial circumflex femoral artery was originated directly from femoral artery. In 10 extremities (9.80% a common trunk was observed form medial circumflex femoral with femoral artery. Normal study was observed in 66 extremities (64.70%. Conclusion: In present study and other past studies we conclude that knowledge of variation in this artery is very important to preventing injury to vessels during surgical procedures around hip joint and also has important value in plastic surgery operations as the vascular pedicle of grafts such as the transverse upper gracilis (TUG flap, medial thigh flap and medial circumflex femoral (gracilis perforator free flap. During case of selective arteriography in ischaemic necrosis of the femoral head to know the arterial supply of the femoral head it is used.

  4. Arterial Ligation for Infected Femoral Psuedo-Aneurysm in Drug Injecting Abusers

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    Mohammadzade Mohammad Ali

    2009-10-01

    Full Text Available Pseudo-aneurysm of the femoral artery is the most common arterial complication in drug injecting abusers. Scholars in vascular surgery have published debating statements regarding techniques of successful surgical management during last two decades. We present the results of simple arterial ligation in a series of 32 patients presenting with infected femoral pseudo-aneurysm. Most of the patients were males (89%. Young persons in the age group of 15-44 years were mostly affected. Site of lesion included common femoral artery in 65% , superficial femoral artery 28% and at bifurcation 6.2%. celulitis in 14 (53%, abscess & "ncelulitis in 6 (19%, necrosing fasciitis in 2 (6.2% and vascular abscess in 7 (22% cases were the forms of associated local infection. There was no hemorrhage, vascular thrombosis, amputation, or mortality. Claudicating were the only complications identified in 2 patients with Tripe ligation. Ligation is the optimal management for infected pseudo-aneurysms because it is easy, cost-effective, and safe. Early reconstruction is not recommended, since there is an extended infection in the location of the pseudo-aneurysm.

  5. A CADAVERIC STUDY OF VARIATIONS IN THE ORIGIN OF LATERAL CIRCUMFLEX FEMORAL ARTERY

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    Apurva Pradipkumar Darji

    2015-12-01

    Full Text Available Introduction: The lateral circumflex femoral artery is a branch of the profunda femoris artery, which is the largest branch of femoral artery. The knowledge of origin and branching patterns of the lateral circumflex femoral artery is valuable for various surgeries and clinical procedures. Objectives: To determine mode of origin of lateral circumflex femoral artery and to determine the distance of origin of lateral circumflex femoral artery from the origin of profunda femoris artery and from mid-inguinal point. Materials and Method: 130 femoral triangles were studied and various measurements were noted and analysed from the department of anatomy of various Medical colleges of Gujarat. Result and conclusion: The lateral circumflex femoral artery originated from profunda femoris artery in 119 cases and from femoral artery in 11 cases. In most of the cases, the distance of origin of lateral circumflex femoral artery from the origin of profunda femoris artery was ranging from 11 to 40 mm on both the sides.

  6. Superficial Ulnar Artery Associated with Anomalous Origin of the Common Interosseous and Ulnar Recurrent Arteries

    Science.gov (United States)

    Pamidi, Narendra; Nayak, Satheesha B; Jetti, Raghu; Thangarajan, Rajesh

    2016-01-01

    Occurrence of vascular variations in the upper limb is not uncommon and is well described in the medical literature. However, occurrence of superficial ulnar artery associated with unusual origin of the common interosseous and ulnar recurrent arteries is seldom reported in the literature. In the present case, we report the anomalous origin of common trunk of common interosseous, anterior and posterior ulnar recurrent arteries from the radial artery, in a male cadaver. Further, ulnar artery had presented superficial course. Knowledge of anomalous arterial pattern in the cubital fossa reported here is clinically important during the angiographic procedures and plastic surgeries. PMID:27437201

  7. Novel femoral artery terminology: integrating anatomy and clinical procedures leading to standardized intuitive nomenclature.

    Science.gov (United States)

    Benninger, Brion

    2014-10-01

    The objective of this study is to investigate the terminology of the femoral artery and recommended alternative terminology that satisfies both anatomy and clinical arenas.The femoral artery (FA) is often defined as the continuation of the external iliac artery. Specifically, when the external iliac artery reaches directly beneath the inguinal ligament, it becomes the FA. Currently, Terminologia Anatomica (TA) records the profunda femoris or deep femoral as a terminal branch. Clinicians often use superficial femoral artery (SFA) rather than FA and profunda or deep FA. SFA is actually very deep and well protected for most of its journey. On observation, the terminology in current use is not intuitive. The objective of this study was to investigate the terminology associated with the anatomical and clinical anatomical interpretations of the FA and its terminal branches and to suggest a more appropriate terminology that addresses the points of view of the macro anatomist, as well as that of the clinician. Literature search was conducted regarding the nomenclature of the FA and its terminal branches. Dissection of 89 embalmed cadavers (49F, 40M, ages 47-89) was conducted to analyze the morphology of the FA and its branches. Perusal of the literature revealed a difference in terminology between anatomical and clinical textbooks/atlases/journals regarding the FA and its terminal branch. Our dissections suggested that the FA may be better defined vis-à-vis its relationship to the anterior and posterior compartments of the thigh. A difference in terminology exists between the anatomical and clinical arenas. A need for a standardized terminology is necessary because clinicians and their publishers have not adopted TA. This study suggests that the current FA be considered the common FA and the continuation of the FA, the SFA be renamed the anterior FA and the current profunda (the deep FA) be renamed the posterior FA, respectively. The proposed terminology mirrors the lower

  8. Carotid artery stenting by non-femoral arterial approach in patients with difficult anatomy

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    R V Narayana

    2013-01-01

    Full Text Available Background: Carotid endarterectomy (CEA and carotid artery stenting (CAS are safe, effective, and standard methods to treat significant carotid artery stenosis. CAS is generally performed through femoral arterial access. We had six patients with significant carotid artery stenosis, who had difficult anatomy prohibiting a trans-femoral CAS. Those patients were given an option for CEA. However, they refused for surgical intervention. Aim: We investigated the feasibility of performing CAS from a non-femoral arterial approach in patients with difficult anatomies like severe aortic/aorto-iliac disease, tortuous aortic arch, and tortuous carotid artery origin. Materials and Methods: Six patients with difficult anatomy presented to us with either transient ischemic attack or stroke with high-grade carotid artery stenosis. Out of the six patients, three had aorto-iliac disease, one had high-grade coarctation of aorta, two had tortuous aortic arch and or tortuous carotid artery origin. All these patients were treated with CAS though non-femoral arterial route. Results: CAS could be done successfully in all these six patients; four of them were done through trans-brachial arterial route and two were done through a direct carotid artery puncture. There were no new neurological deficits seen in any of the patient post-procedure. Conclusion: CAS can be done safely through non-femoral arterial approach in patients with difficult anatomy.

  9. Medial circumflex femoral artery flap for ischial pressure sore

    Science.gov (United States)

    Palanivelu, S.

    2009-01-01

    A new axial pattern flap based on the terminal branches of the medial circumflex femoral artery is described for coverage of ischial pressure sore. Based on the terminal branches of the transverse branch of medial circumflex femoral artery, which exit through the gap between the quadratus femoris muscle above and the upper border of adductor magnus muscle below, this fascio cutaneous flap is much smaller than the posterior thigh flap but extremely useful to cover ischeal pressure sores. The skin redundancy below the gluteal fold allows a primary closure of the donor defect. It can also be used in combination with biceps femoris muscle flap. PMID:19881020

  10. Angioplasty of the pelvic and femoral arteries in PAOD: Results and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Balzer, Joern O., E-mail: balzerjo@t-online.d [Dept. for Radiology and Nuclear medicine, Catholic Clinic Mainz, An der Goldgrube 11, 55131 Mainz (Germany); Thalhammer, Axel [Dept. of Diagnostic and Interventional Radiology, Univ. Clinic, Johann Wolfgang Goethe-University Frankfurt/Main (Germany); Khan, Verena [Dept. of Diagnostic and Interventional Radiology, Clinic Nuernberg North (Germany); Zangos, Stefan; Vogl, Thomas J.; Lehnert, Thomas [Dept. of Diagnostic and Interventional Radiology, Univ. Clinic, Johann Wolfgang Goethe-University Frankfurt/Main (Germany)

    2010-07-15

    Purpose: Evaluation of percutaneous recanalization of obstructed iliac as well as superficial femoral arteries (SFAs) in patients with peripheral arterial obstructive disease (PAOD). Material and methods: The data of 195 consecutive patients with 285 obstructions of the common and or external iliac artery as well as the data of 452 consecutive patients with 602 long occlusions (length > 5 cm) of the SFA were retrospectively analyzed. The lesions were either treated with percutaneous transluminal angioplasty (PTA) or Excimer laser assisted percutaneous transluminal angioplasty (LPTA). Overall 316 stents were implanted (Nitinol stents: 136; stainless steel stents: 180) in the iliac artery and 669 stents were implanted (Nitinol stents: 311; Easy Wallstents: 358) in the SFA. The follow-up period was 36-65 months (mean 46.98 {+-} 7.11 months) postinterventionally using clinical examination, ABI calculation, and color-coded duplex sonography. Patency rates were calculated on the basis of the Kaplan-Meier analysis. Results: The overall primary technical success rate was 97.89% for the iliac arteries and 92.35% for the SFA. Minor complications (hematoma, distal emboli and vessel dissection) were documented in 11.79% for the iliac arteries and 7.97% for the SFA. The primary patency rate was 90.3% for the iliac and 52.8% for the SFA after 4 years. The secondary patency rate was 96.84% for the iliac and 77.8% for the SFA after 4 years. Conclusion: Percutaneous recanalization of iliac and superficial femoral artery obstructions is a safe and effective technique for the treatment of patients with PAOD. By consequent clinical monitoring high secondary patency rates can be achieved. The use of a stents seems to result in higher patency rate especially in the SFA when compared to the literature in long-term follow-up.

  11. A rare variant of the superficial ulnar artery, and its clinical implications: a case report

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    Senanayake Kithsiri J

    2007-11-01

    Full Text Available Abstract The superficial ulnar artery is a rare variation of the upper limb arterial system that arises from the brachial or axillary artery and runs superficial to the muscles arising from the medial epicondyle 123. The incidence is about 0.7 to 7% 145. In our routine dissections we found a superficial ulnar artery, which crossed the cubital fossa superficial to the bicipital aponeurosis making it highly vulnerable to intra-arterial injection. This is a rare variation that every medical and nursing staff member should know about.

  12. Immediate Bilateral Breast Reconstruction with Unilateral Deep Superior Epigastric Artery and Superficial Circumflex Iliac Artery Flaps

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    Keith S. Hansen

    2016-09-01

    Full Text Available Autologous breast reconstruction utilizing a perforator flap is an increasingly popular method for reducing donor site morbidity and implant-related complications. However, aberrant anatomy not readily visible on computed tomography angiography is a rare albeit real risk when undergoing perforator flap reconstruction. We present an operative case of a patient who successfully underwent a bilateral breast reconstruction sourced from a unilateral abdominal flap divided into deep superior epigastric artery and superficial circumflex iliac artery flap segments.

  13. Numerical simulation of blood flow in femoral perfusion: comparison between side-armed femoral artery perfusion and direct femoral artery perfusion.

    Science.gov (United States)

    Kitamura, Shingo; Shirota, Minori; Fukuda, Wakako; Inamura, Takao; Fukuda, Ikuo

    2016-12-01

    Computational numerical analysis was performed to elucidate the flow dynamics of femoral artery perfusion. Numerical simulation of blood flow was performed from the right femoral artery in an aortic model. An incompressible Navier-Stokes equation and continuity equation were solved using computed flow dynamics software. Three different perfusion models were analyzed: a 4.0-mm cannula (outer diameter 15 French size), a 5.2-mm cannula (18 French size) and an 8-mm prosthetic graft. The cannula was inserted parallel to the femoral artery, while the graft was anastomosed perpendicular to the femoral artery. Shear stress was highest with the 4-mm cannula (172 Pa) followed by the graft (127 Pa) and the 5.2-mm cannula (99 Pa). The cannula exit velocity was high, even when the 5.2-mm cannula was used. Although side-armed perfusion with an 8-mm graft generated a high shear stress area near the point of anastomosis, flow velocity at the external iliac artery was decreased. The jet speed decreased due to the Coanda effect caused by the recirculation behind sudden expansion of diameter, and the flow velocity maintains a constant speed after the reattachment length of the flow. This study showed that iliac artery shear stress was lower with the 5.2-mm cannula than with the 4-mm cannula when used for femoral perfusion. Side-armed graft perfusion generates a high shear stress area around the anastomotic site, but flow velocity in the iliac artery is slower in the graft model than in the 5.2-mm cannula model.

  14. Superficial Circumflex Iliac Artery Perforator Flap for Dorsalis Pedis Reconstruction.

    Science.gov (United States)

    Tashiro, Kensuke; Yamashita, Shuji

    2017-04-01

    Reconstruction of dorsalis pedis with soft tissue is challenging because it needs to preserve thin structure to ensure that the patient will be able to wear shoes. Here, we report the use of a thin superficial circumflex iliac artery perforator (SCIP) flap in dorsalis pedis reconstruction. A 67-year-old man presented with a third-degree burn, which exposed his extensor tendons. A thin SCIP flap from the left inguinal region measuring 15 × 4 cm was transferred to the dorsalis pedis region. Postoperatively, no major cosmetic or functional problems were observed. Because the invasiveness of the donor site is nearly same between SCIP flap and skin graft from inguinal region, SCIP flap is better solution in point of textural qualities for dorsalis pedis reconstruction.

  15. [Percutaneous angioscopy of the iliac and femoral arteries].

    Science.gov (United States)

    Cécile, J P; Foucart, H; Carlier, C; Baudrillard, J C; Varloteaux, M C; Servais, B; Bourgois, L

    1988-01-01

    Very few papers about peripheral angioscopy are reported in literature. Percutaneous angioscopy (P.T.A.) of 25 peripheral arteries (21 iliac and 4 femoral arteries) have been performed by the authors without surgery and without anesthesia. Three observations are selected. The first one demonstrates an eccentric stenosis altering its diameter during pulsations; an irregular ulcerated atheroma is observed. The second case shows the signs of a centric atheroma with an intimal fragment. The last one is an intimal dissection due to PTA. The prospective aspects of this new technique are discussed.

  16. Femoral artery pressure measurement to predict the outcome of arterial surgery in patients with multilevel disease

    DEFF Research Database (Denmark)

    Faris, I; Tønnesen, K H; Agerskov, K;

    1982-01-01

    Direct measurement of the femoral artery pressure before operation has been used to predict the postoperative change in ankle and toe pressure in 102 limbs (83 patients) that underwent aortoiliac surgery for the treatment of atherosclerotic occlusion or stenosis affecting both the aortoiliac...... and femoral artery segments. Rest pain or gangrene was present in 74 limbs. In 26 other limbs simultaneous aortoiliac and femoral artery reconstructions were performed. The changes in both toe and ankle pressures could be confidently predicted from the preoperative data. A predicted toe pressure of lower than...... 25 mm Hg was associated with a high probability that amputation would be required. The chances of an amputation were less than 3% if a toe pressure higher than 40 mm Hg was predicted. If the predicted ankle pressure index was lower than 0.56, there was a 90% chance that intermittent claudication...

  17. Trifurcation of superficial brachial artery: a rare case with its clinico-embryological implications.

    Science.gov (United States)

    Gupta, N; Anshu, A; Dada, R

    2014-01-01

    Literatures on vasculature of upper limbs are crammed with reports of distinctly deviant version of normally prevalent vessels having modified origins, altered branching and odd courses. A unique anatomical variation in vascular pattern was observed during routine dissection of right upper limb in gross anatomy laboratory, AIIMS, New Delhi, India. The brachial artery was placed superficial to median nerve in the arm and therefore it was called superficial brachial artery. In the cubital fossa, 2.8 cm distal to intercondylar line of elbow joint, this superficial brachial artery terminated by trifurcation into radial, common interosseous and ulnar branches. Strikingly the ulnar branch, after its origin ran superficially over the median nerve and epitrochlear superficial flexor group of muscles of forearm in succession for the initial third of its course in the forearm, consequently it was addressed as superficial ulnar artery. The existence of superficial brachial artery in place of normal brachial artery, its termination by trifurcation into radial, common interosseous and superficial ulnar arteries with remarkably different courses, leads to confusing disposition of structures in the arm, cubital fossa and in the forearm and collectively makes this myriad of anatomical variations even rarer. The clinico-embryological revelations for combination of these unconventional observations, apprises and guides the specialized medical personnel attempting blind and invasive procedures in brachium and ante-brachium. This case report depicts the anatomical perspective and clinical implications on confronting a rare variant vasculature architecture pattern of upper limb.

  18. Branch facial nerve trauma after superficial temporal artery biopsy: a case report

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    Rison Richard A

    2011-01-01

    Full Text Available Abstract Introduction Giant cell arteritis is an emergency requiring prompt diagnosis and treatment. Superficial temporal artery biopsy is the gold diagnostic standard. Complications are few and infrequent; however, facial nerve injury has been reported, leaving an untoward cosmetic outcome. This case report is to the best of our knowledge only the fourth one presented in the available literature so far regarding facial nerve injury from superficial temporal artery biopsy. Case presentation A 73-year-old Caucasian woman presented for neurological evaluation regarding eyebrow and facial asymmetry after a superficial temporal artery biopsy for presumptive giant cell arteritis-induced cephalalgia. Conclusion Damage to branches of the facial nerve may occur after superficial temporal artery biopsy, resulting in eyebrow droop. Although an uncommon and sparsely reported complication, all clinicians of various specialties involved in the care of these patients should be aware of this given the gravity of giant cell arteritis and the widespread use of temporal artery biopsy.

  19. A method to quantify and visualize femoral head intraosseous arteries by micro-CT.

    Science.gov (United States)

    Qiu, Xing; Shi, Xiaotian; Ouyang, Jun; Xu, Dachuan; Zhao, Dewei

    2016-08-01

    We describe a technique for perfusing a barium sulphate suspension into the intraosseous artery. Following the perfusion of abarium sulphate suspension into 14 fresh lower limbs of Chinese cadavers, micro-CT scanning was applied to digitize, quantify and visualize the intraosseous arteries in the human femoral heads. Then, the femoral heads were removed and subjected to micro-CT scanning. The data were imported into the amira and mimics programs to reconstruct and quantify the intraosseous arteries. The femoral head intraosseous artery lengths, areas, volumes, and femoral head bone volumes were quantified. The artery densities and artery ratios were calculated and analysed with independent-samples t-tests. The intraosseous vasculature volume renderings were displayed as screenshots and videos made with amira. Many intraosseous artery study technologies were compared. The barium sulphate suspension was milky white in colour. The perfusion of the barium sulphate suspension followed by micro-CT scanning provided a good representation of the intraosseous artery. The femoral head intraosseous artery lengths, areas and volumes, and the femoral head bone volumes were displayed as the X¯±S . No differences were observed between the left and right femoral head intraosseous arteries in terms of the artery densities or artery ratios. The volume renderings and 3-D orthogonal projections displayed the overall distributions of the intraosseous arteries. The videos clearly demonstrated the entry sites of the nutrition-carrying arteries, their courses and branches, and the intraosseous arterial anastomoses. Our technique is the simplest and least time-consuming method of producing accurate vascular three-dimensional reconstructions. The perfusion of a barium sulphate suspension into intraosseous arteries combined with micro-CT scanning can deliver high-resolution 3-D digitized data and images of intraosseous arteries. This technique does not require bone decalcification or bone

  20. Arterial Misplacement of a Femoral Central Venous Catheter Complicated with Acute Arterial Occlusion

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    Hung-Lung Hung

    2005-03-01

    Full Text Available Femoral vein catheterization is often carried out during resuscitation and in critical care units. It is usually achieved via a blind, external landmark-guided technique, through manual localization of the femoral artery. However, this approach can be challenging in patients with severe shock because of absence or ambiguity of the arterial pulse. We report a case of inadvertent cannulation, with a large-bore catheter, of the right femoral artery, which was mistaken as a venous route for medication and massive transfusion. The large cannula caused direct mechanical obstruction, while intra-arterial medications induced vascular injury and vasospasm. Both factors led to thrombosis and occlusion of the right external iliac artery, thus jeopardizing the distal blood supply, and ultimately resulting in muscle necrosis of the involved limb, and the need for thrombectomy and extensive fasciotomy to salvage the extremity. This case highlights that correct placement of a central venous catheter should be clearly ascertained before the catheter is used for medical treatment, especially when catheterization is performed in shock status.

  1. From puncture to closure of the common femoral artery in endovascular aortic repair

    DEFF Research Database (Denmark)

    Lönn, Lars; Larzon, Thomas; Van Den Berg, Jos C

    2010-01-01

    or epidural anesthesia. The evolving stent-technology with smaller sheath sizes has broadened the scenario for alternative approaches for access and closure of the common femoral arteries. The following review presents an introduction on technical aspects of puncture of the femoral artery and closure...

  2. Risk Factors for Surgical-Site Infection Following Common Femoral Artery Endarterectomy

    NARCIS (Netherlands)

    Derksen, Wouter J. M.; Verhoeven, Bart A. N.; van de Mortel, Rob H. W.; Moll, Frans L.; de Vries, Jean-Paul P. M.

    2009-01-01

    Surgical-site infection is a major complication following endarterectomy of the common femoral artery. The aim of this single-center study was to determine risk factors for surgical-site infection after endarterectomy of the common femoral artery and especially the possible association between patch

  3. Cadaveric study: study of lateral circumflex femoral arterial origin in Rajkot

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    Pradip Rameshbhai Chauhan

    2015-05-01

    Full Text Available Background: Lateral circumflex femoral artery contributes cruciate, trochanteric and knee joint anastomosis. In addition Lateral circumflex femoral artery flaps are used for the reconstruction of large tissue loss in the head and neck region, aortopopliteal bypass, coronary artery bypass grafting and extracranial intracranial bypass surgery. This work was carried out (a to study the origin of lateral circumflex femoral artery and (b to measure and compare (between male and female the circumference at its origin. Methods: In this cross sectional study, 51 femoral triangles from 26 (18 male and 08 female human adult cadavers were dissected and studied at P.D.U. government medical college, Rajkot, Gujarat. Site of origin of lateral circumflex femoral artery was identified and noted. The distance of origin of the artery from the origin of profunda femoris artery was measured and noted. Circumference at the level of origin was measured and diameter was calculated. Collected data was analysed by standard statistical formulas with the help of Microsoft excel 2013 and Epi info 7TM software. Results: 90.19% lateral circumflex femoral arteries originated from the profunda femoris artery and remaining 9.81% from the femoral artery. The mean distance of origin of the artery from the origin of profunda femoris artery was 18.44 mm. Lateral circumflex femoral artery circumference and diameter were significantly different between male and female (95% confidence interval, P <0.05. Conclusion: In this presented study maximum distance of origin of the artery from the origin was 65 mm while minimum distance of origin was 6 mm. In addition difference in circumference of the artery was statistically significant. [Int J Res Med Sci 2015; 3(5.000: 1066-1069

  4. Comparison of femoral and auricular arterial blood pressure monitoring in pigs.

    Science.gov (United States)

    Bass, Louise M E; Yu, Dao-Yi; Cullen, Len K

    2009-09-01

    To compare arterial blood pressure measurements obtained from the femoral and auricular arteries in anaesthetized pigs. Prospective experimental study. Fifteen female Large White pigs were used weighing 21.3 +/- 2.3 kg. The pigs were anaesthetized with tiletamine/zolazepam and xylazine administered intramuscularly, and anaesthesia maintained with isoflurane delivered in oxygen/nitrogen. Arterial oxygen partial pressures were maintained between 11.3 and 13.3 kPa and PaCO(2) between 4.6 and 6.0 kPa. Monitoring included electrocardiogram, capnography and invasive blood pressure. The auricular and femoral arteries were catheterized for continuous systolic (SAP), diastolic (DAP) and mean arterial pressure (MAP) measurements. Measurements were recorded every 15 minutes. Statistical analysis involved a Bland-Altman plot analysis. The mean difference +/- confidence intervals between the femoral and the auricular arterial diastolic, systolic and mean blood pressure measurements during hypotension were 2 +/- 7, 2 +/- 5 and 2 +/- 5 mmHg respectively. In conditions of normotension mean difference +/- confidence intervals, of femoral and auricular arterial blood pressure measurements of diastolic, systolic and mean blood pressure were 4 +/- 5, 3 +/- 7 and 4 +/- 4 mmHg respectively. In conditions of increased arterial blood pressure, mean difference +/- confidence intervals, of femoral and auricular arterial blood pressure measurements of diastolic, systolic and mean blood pressure were 4 +/- 5, 3 +/- 8 and 4 +/- 4 mmHg respectively. Auricular artery catheterization is easier and quicker to perform. Pressure measurements from the auricular artery compared well with the femoral artery. We found that auricular arterial blood pressures were similar to femoral arterial values under the conditions of this experiment. We did not test extremes of blood pressure or significant alterations in body temperature.

  5. Superficial temporal artery to proximal posterior cerebral artery bypass through the anterior temporal approach

    Directory of Open Access Journals (Sweden)

    Satoru Takeuchi

    2015-01-01

    Full Text Available Background: The superficial temporal artery (STA to proximal posterior cerebral artery (PCA (P2 segment bypass is one of the most difficult procedures to perform because the proximal PCA is located deep and high within the ambient cistern. STA to proximal PCA bypass is usually performed through a subtemporal approach or posterior transpetrosal approach, and rarely through a transsylvian approach. The aim of this study was to describe the operative technique of STA to proximal PCA bypass through a modified transsylvian approach (anterior temporal approach. Methods: STA to proximal PCA bypass was performed through an anterior temporal approach in three patients with intracranial aneurysm. We describe the details of the surgical technique. Results: The STA was successfully anastomosed to the proximal PCA in all cases. One patient suffered hemiparesis and aphasia due to infarction in the anterior thalamoperforating artery territory. Conclusions: STA to proximal PCA bypass can be performed through an anterior temporal approach in selected patients. We recommend that every precaution, including complete hemostasis, placement of cellulose sponges beneath the recipient artery to elevate the site of the anastomosis, and placement of a continuous drainage tube at the bottom of the operative field to avoid blood contamination during the anastomosis, should be taken to shorten the temporary occlusion time.

  6. [Femoral superficial vein thrombosis due to a large iliopsoas bursitis secondary to polyethylene wear debris in total hip arthroplasty].

    Science.gov (United States)

    Lax Pérez, R; Salinas Gilabert, J E; Lajara Marco, F; Lax Pérez, A; Ferrero Manzanal, F; García-Gálvez, A; Izquierdo Plazas, L

    2012-01-01

    A 76 year old male patient with a history of implantation of a total hip arthroplasty Perfecta (Orthomet(®)), who presented with an iliac fossa mass, increased diameter of the thigh, and pain during hip flexion and extension. CT and ultrasound show the presence of a giant cystic mass in left iliac fossa about 7 cm in diameter next to the prosthesis. A pseudo-tumour secondary to wear debris after placement of a total arthroplasty is rare. We present a case of a large iliopsoas bursitis caused by polyethylene particles, which caused compression and thrombosis of the superficial femoral vein. Copyright © 2011 SECOT. Published by Elsevier Espana. All rights reserved.

  7. [Superficial femoral vein thrombosis due to large psoas bursitis secondary to particle disease in total hip arthroplasty].

    Science.gov (United States)

    Lax-Pérez, R; Salinas-Gilabert, J E; Lajara-Marco, F; Lax-Pérez, A; Corraliza-Zamorano, A; García-Gálvez, A; Izquierdo-Plazas, L

    2012-01-01

    Male, 76 year-old patient with a history of total hip arthroplasty who presents with a mass in the iliac fossa with swelling of the thigh and hip pain upon flexion and extension. Complementary ultrasound and computed tomography scan studies show a giant lobulated cystic mass in the left iliac fossa, 7 cm in diameter, near the prosthesis. Cyst formation caused by polyethylene disease after total hip arthroplasty is infrequent. We present a case of large psoas bursitis secondary to the release of polyethylene particles which caused superficial femoral vein compression and thrombosis.

  8. Comparison of Ultrasound-Guided and Fluoroscopy-Assisted Antegrade Common Femoral Artery Puncture Techniques

    Energy Technology Data Exchange (ETDEWEB)

    Slattery, Michael M.; Goh, Gerard S.; Power, Sarah; Given, Mark F.; McGrath, Frank P.; Lee, Michael J., E-mail: mlee@rcsi.ie [Beaumont Hospital, Department of Radiology (Ireland)

    2015-06-15

    PurposeTo prospectively compare the procedural time and complication rates of ultrasound-guided and fluoroscopy-assisted antegrade common femoral artery (CFA) puncture techniques.Materials and MethodsHundred consecutive patients, undergoing a vascular procedure for which an antegrade approach was deemed necessary/desirable, were randomly assigned to undergo either ultrasound-guided or fluoroscopy-assisted CFA puncture. Time taken from administration of local anaesthetic to vascular sheath insertion in the superficial femoral artery (SFA), patients’ age, body mass index (BMI), fluoroscopy radiation dose, haemostasis method and immediate complications were recorded. Mean and median values were calculated and statistically analysed with unpaired t tests.ResultsSixty-nine male and 31 female patients underwent antegrade puncture (mean age 66.7 years). The mean BMI was 25.7 for the ultrasound-guided (n = 53) and 25.3 for the fluoroscopy-assisted (n = 47) groups. The mean time taken for the ultrasound-guided puncture was 7 min 46 s and for the fluoroscopy-assisted technique was 9 min 41 s (p = 0.021). Mean fluoroscopy dose area product in the fluoroscopy group was 199 cGy cm{sup 2}. Complications included two groin haematomas in the ultrasound-guided group and two retroperitoneal haematomas and one direct SFA puncture in the fluoroscopy-assisted group.ConclusionUltrasound-guided technique is faster and safer for antegrade CFA puncture when compared to the fluoroscopic-assisted technique alone.

  9. The superficial ulnar artery: development and clinical significance Artéria ulnar superficial: desenvolvimento e relevância clínica

    Directory of Open Access Journals (Sweden)

    Srinivasulu Reddy

    2007-09-01

    Full Text Available The principal arteries of the upper limb show a wide range of variation that is of considerable interest to orthopedic surgeons, plastic surgeons, radiologists and anatomists. We present here a case of superficial ulnar artery found during the routine dissection of right upper limb of a 50-year-old male cadaver. The superficial ulnar artery originated from the brachial artery, crossed the median nerve anteriorly and ran lateral to this nerve and the brachial artery. The superficial ulnar artery in the arm gave rise to a narrow muscular branch to the biceps brachii. At the elbow level the artery ran superficial to the bicipital aponeurosis where it was crossed by the median cubital vein. It then ran downward and medially superficial to the forearm flexor muscles, and then downward to enter the hand. At the palm, it formed the superficial and deep palmar arches together with the branches of the radial artery. The presence of a superficial ulnar artery is clinically important when raising forearm flaps in reconstructive surgery. The embryology and clinical significance of the variation are discussed.As principais artérias do membro superior apresentam uma ampla variação, que é relativamente importante a cirurgiões ortopédicos e plásticos, radiologistas e anatomistas.Apresentamosumcaso de artéria ulnar superficial encontrada durante dissecção de rotina de membro superior direito de um cadáver masculino de 50 anos de idade.Aartéria ulnar superficial originava-se da artéria braquial, cruzava o nervo mediano anteriormente e percorria lateralmente esse nervo e a artéria braquial. A artéria ulnar superficial no braço deu origem a um ramo muscular estreito do músculo bíceps braquial. Ao nível do cotovelo, a artéria percorria superficialmente a aponeurose bicipital, onde era cruzada pela veia cubital mediana. Percorria, então, em sentido descendente e medialmente superficial aos músculos flexores do antebraço, e então descendia para

  10. A new noninvasive device for continuous arterial blood pressure monitoring in the superficial temporal artery.

    Science.gov (United States)

    Chin, K Y; Panerai, R B

    2013-04-01

    Continuous recording of arterial blood pressure (ABP) has many applications in cardiovascular physiology, but existing alternatives rely on measurements performed in the fingers or radial artery. Peripheral recordings have significant differences from central ABP regarding the pattern of the waveform and corresponding systolic and diastolic values. To address the need for noninvasive measurements closer to the ascending aorta, a new device was constructed to measure ABP in the superficial temporal artery (STA) using photoplethysmography and the arterial volume clamping technique. The optoelectronic circuitry to generate the photoplethysmogram is contained in a specially designed probe placed over the STA and kept in place with a head frame. The prototype (STAbp) also includes original designs for the pneumatic, electronic, signal processing, control and display sub-systems. A self-calibration feature regularly updates the photoplethysmogram operating point to improve accuracy. The performance of the STAbp was compared against the Finapres in 19 healthy subjects. At rest, the bias (SDd) was -23.1 (15.05), -10.8 (13.83) and -12.4 (12.93) mmHg for systolic, mean and diastolic pressures respectively, without significant differences in drift between the two devices. The 99% bandwidth (SD) for the spectral distribution of ABP waveforms was 5.3 (1.46) Hz for STAbp and 6.8 (0.73) Hz for the Finapres (p < 0.01). Handgrip manoeuvre showed a very similar response to the Finapres, including the rapid return to baseline on release. The new STAbp device has considerable potential as a new tool for clinical and research applications where continuous recording of more central ABP is advantageous compared to peripheral alternatives.

  11. Characterization of plaque components with intravascular ultrasound elastography in human femoral and coronary arteries in vitro

    NARCIS (Netherlands)

    C.L. de Korte (Chris); G. Pasterkamp (Gerard); H.A. Woutman; N. Bom (Klaas); A.F.W. van der Steen (Ton)

    2000-01-01

    textabstractBACKGROUND: The composition of plaque is a major determinant of coronary-related clinical syndromes. Intravascular ultrasound (IVUS) elastography has proven to be a technique capable of reflecting the mechanical properties of phantom material and the femoral arterial

  12. Balloon catheterization for hemostasis during the operation of ruptured femoral artery pseudoaneurysm

    Institute of Scientific and Technical Information of China (English)

    SHI De-bing; FU Wei-guo; WANG Yu-qi; GUO Da-qiao; CHEN Bin; SHI Zhen-yu

    2007-01-01

    @@ Pseudoaneurysms of the femoral artery usually progress and can rupture if left untreated. Therefore,intraoperative hemostasis is of the paramount importance in the management of these emergent situations,especially for the patients with poor general health.

  13. Artéria femoral profunda: uma opção como origem de fluxo para derivações infrageniculares Deep femoral artery: an option as inflow site in infragenicular bypasses

    Directory of Open Access Journals (Sweden)

    Francisco Cardoso Brochado Neto

    2008-09-01

    Full Text Available CONTEXTO: Na isquemia crítica, a artéria femoral profunda pode tornar-se a opção mais distal como origem de fluxo para derivações distais em casos de oclusão da origem da artéria femoral superficial associada a prega inguinal hostil. OBJETIVO:Avaliar, retrospectivamente, a artéria femoral profunda como doadora de fluxo para derivações infrageniculares. MÉTODOS: De 2000 a 2005, 129 derivações infrageniculares apresentaram anastomose proximal nas artérias femorais, comum (40, superficial (72 e profunda (17. O presente estudo teve como foco a artéria femoral profunda, e suas indicações foram: prega inguinal hostil (seis casos, limite da extensão do substituto (seis casos e ambos os fatores (outros cinco casos. Foram abordadas a primeira e a segunda porção em 12 casos e a terceira porção em cinco casos. As cirurgias foram secundárias em 47% dos casos, e os substitutos utilizados foram veias do membro superior em 11 casos, safena interna em cinco e safena externa em um caso. RESULTADOS: No total dos enxertos (129, as estimativas de perviedade primária e salvamento do membro foram: 68,0% e 84,7%, respectivamente, com erro padrão (EP aceitável (0,1 em 36 meses. Quando o grupo foi estratificado, as artérias femorais comum, superficial e profunda apresentaram resultados comparáveis de perviedade primária (63,3, 70,2 e 64,7%; p = 0,63 e salvamento do membro (83,1, 82,4 e 92,3%; p = 0,78. A perviedade dos enxertos com origem nas porções proximal e distal da artéria femoral profunda, bem como das cirurgias primárias e secundárias, foram comparáveis, sem diferença estatística significante (p = 0,89 e p = 0,77, respectivamente. CONCLUSÃO: A artéria femoral profunda mostrou ser acessível e efetiva como origem de fluxo de enxertos infrageniculares, com resultados satisfatórios de perviedade e salvamento do membro.BACKGROUND: Deep femoral artery can be the most distal technical option as donor site in patients with

  14. Vascular reactivity of rabbit isolated renal and femoral resistance arteries in renal wrap hypertension.

    Science.gov (United States)

    Khammy, Makhala M; Angus, James A; Wright, Christine E

    2016-02-15

    In rabbits with cellophane renal wrap hypertension, hindquarter and total vascular resistance changes to pressor and depressor agents are amplified compared to those of normotensive rabbits. The aim of the present study was to evaluate the in vitro pharmacodynamics of hypertensive and normotensive rabbit small artery segments isolated from the renal and hindquarter vascular beds. Using wire myography, the full range (Emax) and sensitivity (EC50) to a range of agonists of segments of renal interlobar (≈ 600 µm i.d.), renal arcuate (≈ 250 µm i.d.) and deep femoral branch (≈ 250 µm i.d.) arteries were assessed under normalised conditions of passive tension. Interlobar arteries from hypertensive rabbits were more sensitive (EC50) than those from normotensive rabbits to noradrenaline (6-fold), methoxamine (3-fold) and angiotensin II (3-fold). Arcuate artery reactivity was largely unaffected by hypertension. Deep femoral arteries from hypertensive rabbits had enhanced sensitivity only to noradrenaline (2-fold) and methoxamine (4-fold). Sensitivity to relaxation by acetylcholine was unaffected by hypertension in all arteries. Deep femoral arteries from hypertensive rabbits were more sensitive to sodium nitroprusside than normotensive counterparts. Adenosine caused little relaxation in renal arteries, but full relaxation in deep femoral arteries, unaltered by hypertension. This study found substantial heterogeneity in the pharmacodynamic profile of vessels isolated from different vascular beds and between arterial segments within the kidney. These profiles were differentially affected by hypertension suggesting that hypertension per se is not a resultant of general vascular dysfunction.

  15. Acute arterial occlusion in the midpiece of femoral artery following total knee arthroplasty: Report of one case

    Institute of Scientific and Technical Information of China (English)

    Rui He; Liu Yang

    2016-01-01

    Acute arterial occlusion is a rare complication following total knee arthroplasty (TKA).The incidence as reported previously is from 0.03% to 0.17%;however,the sequelae can be disastrous because of its potential threat to limb loss.We report a case of acute arterial occlusion in the midpiece of femoral artery following TKA occurred 40 min postoperatively.The occlusion site existed at the midpiece of femoral artery is uncommon.Arterial circulation of the lower limb could not be restored by the thrombolysis and thrombectomy treatments performed within 11 h after TKA.In the end,amputation had to be carried out.In the treatment of acute arterial occlusion following TKA with a tourniquet,it is important to fully consider that arteriosclerosis may induce atheromatous plaque disruption,which might be the reason for acute arterial occlusion.

  16. [A ruptured mycotic aneurysm of the femoral artery due to Salmonella typhimurium].

    Science.gov (United States)

    Calvo Cascallo, J; Mundi Salvadó, N; Cardona Fontanet, M

    1993-01-01

    Mycotic aneurysms of the femoral artery is rare. We report a new case with a mycotic aneurysm of the femoral artery by "Salmonella typhimurium". The surgical operation was performed as surgical emergence for ruptured aneurysm. We did not know the aneurysm infection origin. The treatment of lesions was resection and femoro-femoral bypass with PTFE. The microbiological examination discovered infection material. A posterior bypass infection required a exeresis bypass and new revascularization with iliofemoral saphenous vein bypass by obturator foramen, and antibiotic treatment prolonged.

  17. Subintimal Arterial Flossing with Antegrade-Retrograde Intervention for Subintimal Recanalization in Treatment of Superficial Femoral Artery Long Segment Occlusion in 16 Patients%双向内膜下血管成形术治疗股浅动脉长段硬化性闭塞疾病16例分析

    Institute of Scientific and Technical Information of China (English)

    徐树彬; 梁志会; 李亮; 刘晶磊; 李佳; 崔进国; 赵红恩; 谢永伟

    2014-01-01

    目的 探讨经双向内膜下血管成形术(subintimal arterial flossing with antegrade retrograde intervention,SAFARI)治疗股浅动脉长段硬化性闭塞疾病的临床效果和应用价值.方法 选择2011年5月—2013年8月收治的经内膜下血管成形术治疗失败的股浅动脉长段硬化性闭塞疾病16例,经SAFARI开通,采用经皮穿刺腔内血管成形术(PTA)联合内支架(stent)置入.结果 全组治疗技术成功率为100%,无严重并发症发生;术后平均随访10(3 ~18)个月,一期通畅率为93.75%(15/16),二期通畅率为100%.踝肱指数由术前的0.25±0.15增加至术后的0.89±0.19(P <0.05).结论 SAFARI是治疗股浅动脉长段硬化性闭塞所致慢性严重肢体缺血的安全有效的方法.

  18. Primary temporal region squamous cell carcinoma diagnosed by a superficial temporal artery biopsy

    DEFF Research Database (Denmark)

    Andersen, S A W; Kiss, K

    2015-01-01

    BACKGROUND: Superficial temporal artery biopsy is a frequent procedure performed in the diagnosis of giant cell arteritis. METHODS AND RESULTS: An otherwise healthy 69-year-old man presented with 2months complaint of right temporal region pain. Giant cell arteritis was suspected and a temporal ar...

  19. Surgical management of multiple posttraumatic arteriovenous fistulas of femoral vessels.

    Science.gov (United States)

    Pokrovsky, A V; Shubin, A A; Kuntsevich, G I; Subbotin, V V; Suntsov, D S

    2008-01-01

    Presented herein are two case reports concerning surgical management of posttraumatic arteriovenous fistulas of femoral vessels. Case 1. A 45-year-old female patient attended with a history of a shotgun injury wound of her left femur and crus sustained when a girl of eight. She sought medical attention for a progressively deteriorating condition, accompanied by pain, and breathlessness dyspnea at rest. Detected were multiple fistulas between the deep femoral artery and superficial femoral artery and femoral vein. Management consisted in separation of the arteriovenous fistulas, followed by prosthetic repair of the deep femoral artery. Case 2. A 32-year-old male patient after an accidentally inflicted shotgun injury of the his left femur underwent within a time period of 3 year three vascular operations including ligation of the deep femoral artery and femoral vein followed by having later on developed secondary lymphedema of his left lower limb and pronounced manifested chronic venous insufficiency. Management included dissociation of the numerous arteriovenous fistulas between the branches of the deep femoral artery and the common femoral artery, as well as between the superficial femoral artery and femoral vein.

  20. First clinical experience with Celt ACD(®) : a femoral arterial puncture closure device.

    LENUS (Irish Health Repository)

    Jan, Aftab

    2013-08-01

    This prospective nonrandomized study compared the safety and efficacy of a novel arterial closure device (ACD) in common femoral artery procedures to that of the FDA submitted historical manual pressure control group, who underwent either a diagnostic angiogram (DA) or a percutaneous coronary intervention (PCI) procedure.

  1. Management of iatrogenic RV injury - RV packing and CPB through PTFE graft attached to femoral artery.

    Science.gov (United States)

    Mangukia, Chirantan V; Agarwal, Saket; Satyarthy, Subodh; Aggarwal, Satish Kumar; Datt, Vishnu; Satsangi, Deepak Kumar

    2015-01-01

    Cardiac injuries during repeat sternotomy are rare. While undergoing debridement for chronic osteomyelitis (post arterial septal defect closure), a 4-year-old girl sustained significant right ventricular (RV) injury. Bleeding from the RV was controlled by packing the injury site, which helped in maintaining stable hemodynamics till arrangements were made for instituting cardiopulmonary bypass (CPB). Since the femoral artery was very small and unsuitable for direct cannulation, a polytetrafluoroethylene (PTFE) graft sutured end-to-side to the femoral artery was used for establishing CPB. The injury was successfully repaired.

  2. Fluoroscopically-guided micropuncture femoral artery access for large-caliber sheath insertion.

    Science.gov (United States)

    Cilingiroglu, Mehmet; Feldman, Ted; Salinger, Michael H; Levisay, Justin; Turi, Zoltan G

    2011-04-01

    Over the last decade, significant developments have been made in the treatment of structural heart disease. Some of these techniques require placement of large arterial sheaths for device delivery. Optimal vascular access is essential for successful large-vessel sheath insertion as well as to avoid vascular complications. The critical step for ideal percutaneous vessel entry is single anterior wall-only puncture of the common femoral artery in a location above the femoral bifurcation and below the inguinal ligament. We describe a fluoroscopically-guided micropuncture technique for accurate placement of large-caliber arterial sheaths.

  3. Symptomatic radial artery thrombosis successfully treated with endovascular approach via femoral access route

    Energy Technology Data Exchange (ETDEWEB)

    Pasha, Ahmed Khurshid [Department of Internal Medicine, University of Arizona (United States); Elder, Mahir D. [Heart and Vascular Institute, Detroit, MI (United States); Division of Cardiology, Wayne State University, Detroit, MI (United States); Malik, Umer Ejaz [Department of Internal Medicine, Texas Tech University Health Science Center at Permian Basin, TX (United States); Khalid, Abdullah Mian [Department of Internal Medicine, University of Pittsburg Medical Center, Mercy Hospital, Pittsburg, PA (United States); Noor, Zeeshan [Department of Internal Medicine, St. Joseph Mercy Hospital, Ann Arbor, MI (United States); Movahed, Mohammad Reza, E-mail: rmova@aol.com [Department of Internal Medicine, University of Arizona (United States); Sarver Heart Center, University of Arizona (United States); CareMore HealthCare, AZ (United States)

    2014-09-15

    Radial access has been increasingly utilized for coronary intervention due to higher safety profile in comparison to femoral access site with lower bleeding rate. Radial artery occlusion is not uncommon with radial access site. This usually does not lead to any harm due to ulnar artery collaterals that are sufficient to prevent hand ischemia and is usually left alone. However, in the case of significant hand ischemia, treatment is often necessary. We are reporting an interesting case of symptomatic radial artery thrombosis leading to arm ischemia that was successfully treated percutaneously using femoral access. Using femoral access for radial artery intervention has not been reported previously. This case is followed by review of the literature.

  4. Suitability of Exoseal Vascular Closure Device for Antegrade Femoral Artery Puncture Site Closure

    Energy Technology Data Exchange (ETDEWEB)

    Schmelter, Christopher, E-mail: christopher.schmelter@klinikum-ingolstadt.de; Liebl, Andrea; Poullos, Nektarios [Klinikum Ingolstadt, Department of Diagnostic and Interventional Radiology (Germany); Ruppert, Volker [Klinikum Ingolstadt, Department of Vascular Surgery (Germany); Vorwerk, Dierk [Klinikum Ingolstadt, Department of Diagnostic and Interventional Radiology (Germany)

    2013-06-15

    Purpose. To assess the efficacy and safety of the Exoseal vascular closure device for antegrade puncture of the femoral artery. Methods. In a prospective study from February 2011 to January 2012, a total of 93 consecutive patients received a total of 100 interventional procedures via an antegrade puncture of the femoral artery. An Exoseal vascular closure device (6F) was used for closure in all cases. Puncture technique, duration of manual compression, and use of compression bandages were documented. All patients were monitored by vascular ultrasound and color-coded duplex sonography of their respective femoral artery puncture site within 12 to 36 h after angiography to check for vascular complications. Results. In 100 antegrade interventional procedures, the Exoseal vascular closure device was applied successfully for closure of the femoral artery puncture site in 96 cases (96 of 100, 96.0 %). The vascular closure device could not be deployed in one case as a result of kinking of the vascular sheath introducer and in three cases because the bioabsorbable plug was not properly delivered to the extravascular space adjacent to the arterial puncture site, but instead fully removed with the delivery system (4.0 %). Twelve to 36 h after the procedure, vascular ultrasound revealed no complications at the femoral artery puncture site in 93 cases (93.0 %). Minor vascular complications were found in seven cases (7.0 %), with four cases (4.0 %) of pseudoaneurysm and three cases (3.0 %) of significant late bleeding, none of which required surgery. Conclusion. The Exoseal vascular closure device was safely used for antegrade puncture of the femoral artery, with a high rate of procedural success (96.0 %), a low rate of minor vascular complications (7.0 %), and no major adverse events.

  5. In vivo noninvasive method for measuring local wave velocity in femoral arteries of pig

    Science.gov (United States)

    Zhang, Xiaoming; Kinnick, Randall; Pislaru, Cristina; Fatemi, Mostafa; Greenleaf, James

    2005-09-01

    We have proposed generating a bending wave in the arterial wall using ultrasound radiation force and measuring the wave velocity along the arterial wall [Zhang et al., IEEE Trans. Ultrason. Ferroelectr. Freq. Control 52, 642-652 (2005)]. Here, we report the results of in vivo studies on pigs. The pig was anesthetized, and a micromanometer tip catheter was inserted into the femoral artery to measure luminal pressure. A water bath was created on the animal's groin to allow unimpeded access of the ultrasound beams to the femoral artery. The femoral artery was first located using a 13-MHz linear-array transducer. Then, a vibro-acoustography image was obtained to ensure precise positioning of the excitation force relative to the artery. The artery was excited by the force transducer and the resulting vibration of the arterial wall was measured by a sensing Doppler transceiver. Measured wave velocity was 3.1 m/s at 300 Hz. With this new method wave velocity over a distance of 5 mm, and therefore stiffness of arteries, can be measured locally and non-invasively. Measurement time is short in a few tens of milliseconds, which allows pressure dependence and pharmacological effect on the wall properties to be measured at different cardiac times.

  6. Large eddy simulation of a stenosed artery using a femoral artery pulsatile flow profile.

    Science.gov (United States)

    Barber, Tracie J; Simmons, Anne

    2011-07-01

    Computational fluid dynamics simulation of stenosed arteries allows the analysis of quantities including wall shear stress, velocity, and pressure; detailed in vivo measurement is difficult yet the analysis of the fluid dynamics related to stenosis is important in understanding the likely causes and ongoing effects on the integrity of the vessel. In this study, a three-dimensional Large Eddy Simulation is conducted of a 50% occluded vessel, with a typical femoral artery profile used as the transient inlet conditions. The fluid is assumed to be homogenous, Newtonian and incompressible and the walls are assumed rigid. The stenosis is axisymmetric, however the three-dimensional study allows for a flow field that is not axisymmetric and results show significant three-dimensionality. High values of wall shear stress and oscillatory values of wall shear stress (varying in both space time) are observed. The results of the study give insight into the time-varying flow structures for a mildly stenosed artery and indicate that three-dimensional simulations may be important to gain a complete understanding of the flow field.

  7. Percutaneous intraluminal recanalization of long, chronic superficial femoral and popliteal occlusions using the Frontrunner XP CTO device: a single-center experience.

    Science.gov (United States)

    Charalambous, Nikolas; Schäfer, Philipp J; Trentmann, Jens; Hümme, Tim H; Stöhring, Christine; Müller-Hülsbeck, Stefan; Heller, Martin; Jahnke, Thomas

    2010-02-01

    The purpose of this study was to examine the safety and efficacy of the Frontrunner XP CTO (chronic total occlusion) Catheter (Cordis) for recanalization of long femoropopliteal artery occlusions. A Frontrunner catheter was used to treat 26 CTOs in SFA after guidewire failure (68.3 +/- 8.8 years). Sixty-seven percent of patients had severe claudication. Critical lower limb ischemia with rest pain or minor tissue loss was present in three and eight patients, respectively. All the lesions were considered complex (TASC B, C, and D); 68% of the lesions were heavily calcified. The mean lesion length was 17.6 cm (range, 10-42 cm). The initial attempt to cross the occlusion with the CTO guidewire V18 was unsuccessful in 26 of 76 limbs (34.26%). A secondary attempt using the Frontrunner catheter (crossover approach, 27%; antegrade, 73%) performed in all 26 failed cases was successful in 17 limbs (65.38%), increasing the technical success rate to 88.12%. The main reasons for failure with the Frontrunner were inability to cross the lesion due to heavy calcification (six of nine) and inability to re-enter the true lumen after subintimal passage of the occluded segment (three of nine). The mean fluoroscopy time was 22.9 min. Minor complications included one distal extension of the dissection with involvement of the first popliteal segment and one perforation in the occluded segment. No major complications were seen. In conclusion, recanalization with the Frontrunner CTO catheter is a simple and safe method with a high technical success rate in the endovascular treatment of long superficial femoral artery occlusions and should be an alternative method after guidewire failure.

  8. Fístula arteriovenosa safeno-femoral superficial como acesso à hemodiálise: descrição de técnica operatória e experiência clínica inicial Superficial saphenofemoral arteriovenous fistula as access to hemodialysis: description of operative technique and initial clinical experience

    Directory of Open Access Journals (Sweden)

    João Antônio Corrêa

    2005-01-01

    Full Text Available OBJETIVO: Descrever uma técnica de confecção de fístula arteriovenosa para acesso à hemodiálise, avaliando os aspectos técnicos de sua confecção, eficácia e complicações. MÉTODO: Foram realizadas 16 fístulas arteriovenosas safeno-femoral superficial em 15 pacientes, no período de agosto de 1998 a outubro de 2000. Esses procedimentos foram efetuados em pacientes sem opções de acesso em membros superiores. A técnica utilizada foi a anteriorização e superficialização da veia safena magna, anastomosando-a na artéria femoral superficial distal. As fístulas arteriovenosas safeno-femoral superficial foram avaliadas quanto à facilidade de punção, fluxo adequado, pressão venosa espontânea, adequação de diálise e complicações no intra-operatório. RESULTADOS: Todas as fístulas puderam ser concluídas com sucesso, sem complicações no intra-operatório. Houve um óbito precoce, porém as demais estavam aptas às punções no 30º dia pós-operatório. Quatorze fístulas foram utilizadas e, na evolução, três pacientes foram submetidos a transplante renal, quatro apresentaram trombose, dois apresentaram pseudoaneurisma de punção. CONCLUSÃO: As fístulas arteriovenosas safeno-femoral superficial mostram-se como boa alternativa para pacientes que não possuem outras possibilidades de acesso em membros superiores, permitindo tratamento hemodialítico eficaz, com boa taxa de perviedade em médio prazo.OBJECTIVE: To describe a technique for creating an arteriovenous fistula as an access to hemodialysis, evaluating its technical aspects, efficacy and complications. METHOD: From August 1998 to October 2000, 16 superficial saphenofemoral arteriovenous fistulas were performed in 15 patients. These procedures were used in patients without access options in upper limbs. The surgical technique consisted of an anteriorization and a superficialization of the saphenous vein anastomosed to the superficial femoral artery in the

  9. [Injury of femoral artery complicated with infection from injection of heroine].

    Science.gov (United States)

    Zhao, X; Li, L; Zhao, H

    1998-11-01

    Drug addiction has been one of the serious social problems. The peripheral phlebitis caused by drug injection is common, but the occurrence of pseudoaneurysm with infection of femoral artery from injection injury was rarely reported in China. From January 1995 to March 1996, six cases of injury of femoral artery with infection from heroine injection were admitted. The characteristics of the injury were described. The therapeutic measures and details of attention to be needed were discussed. It was concluded that this type of injury was different from the injury caused in agricultural, industrial or traffic accidents. The treatment of choice depended upon the type of injury.

  10. [Angioscopy and angioplasty of the iliac and femoral arteries].

    Science.gov (United States)

    Baudrillard, J C; Cécile, J P; Foucart, H; Carlier, C; Baidj, Z

    1990-01-01

    Angioscopy is a technique of endoscopic investigation of the vascular lumen and its contents, which we have coupled with iliac and femoral angioplasty. The material comprises 3 main elements: the angioscope, the TV-monitoring assembly and the infusion system. No complication was recorded in a series of 94 angioscopies (47 iliac, 44 distal femoral and 3 grafts) performed over a period of 18 months. The technical quality of the images obtained was good in 90% of cases (85/94). Angioscopy revealed lesions that had either been nonvisualized or underrated by angiography, and played a determinant role in 16% of cases (15/94), whereby the therapeutical procedure could be modified accordingly.

  11. Selective use of superficial temporal artery cannulation in infants undergoing cardiac surgery

    Directory of Open Access Journals (Sweden)

    Pradeep Bhaskar

    2015-01-01

    Full Text Available Arterial cannulation is routinely performed in children undergoing cardiac surgery to aid the intraoperative and intensive care management. Most commonly cannulated peripheral site in children is radial artery, and alternatives include posterior tibial, dorsalis pedis, and rarely superficial temporal artery (STA. Two specific situations in cardiac surgery where STA cannulation and monitoring was useful during the surgical procedure are reported. To our knowledge, such selective use of STA pressure monitoring has not been reported in the literature previously. Our experience suggests that STA monitoring can be useful and reliable during repair of coarctation of aorta or administration of anterograde cerebral perfusion in patients having associated aberrant origin of the right subclavian artery.

  12. Porphyromonas gingivalis is the most abundant species detected in coronary and femoral arteries

    Science.gov (United States)

    Mougeot, J-L. C.; Stevens, C. B.; Paster, B. J.; Brennan, M. T.; Lockhart, P. B.; Mougeot, F. K. B

    2017-01-01

    ABSTRACT An association between oral bacteria and atherosclerosis has been postulated. A limited number of studies have used 16S RNA gene sequencing-based metagenomics approaches to identify bacteria at the species level from atherosclerotic plaques in arterial walls. The objective of this study was to establish detailed oral microbiome profiles, at both genus and species level, of clinically healthy coronary and femoral artery tissues from patients with atherosclerosis. Tissue specimens were taken from clinically non-atherosclerotic areas of coronary or femoral arteries used for attachment of bypass grafts in 42 patients with atherosclerotic cardiovascular disease. Bacterial DNA was sequenced using the MiSeq platform, and sequence reads were screened in silico for nearly 600 oral species using the HOMINGS ProbeSeq species identification program. The number of sequence reads matched to species or genera were used for statistical analyses. A total of 230 and 118 species were detected in coronary and femoral arteries, respectively. Unidentified species detected by genus-specific probes consisted of 45 and 30 genera in coronary and in femoral artery tissues, respectively. Overall, 245 species belonging to 95 genera were detected in coronary and femoral arteries combined. The most abundant species were Porphyromonas gingivalis, Enterococcus faecalis, and Finegoldia magna based on species probes. Porphyromonas, Escherichia, Staphylococcus, Pseudomonas, and Streptococcus genera represented 88.5% mean relative abundance based on combined species and genus probe detections. Porphyromonas was significantly more abundant than Escherichia (i.e. 46.8% vs. 19.3%; p = 0.0005). This study provides insight into the presence and types of oral microbiome bacterial species found in clinically non-atherosclerotic arteries.

  13. Pseudoaneurysm of profunda femoris artery following dynamic hip screw fixation for intertrochanteric femoral fracture

    Institute of Scientific and Technical Information of China (English)

    Shailendra Singh; Sumit Arora; Ankit Thora; Ram Mohan; Sumit Sural; Anil Dhal

    2013-01-01

    Dynamic hip screw fixation is a commonly performed procedure for internal fixation of intertrochanteric femoral fractures.Arterial injury following the operative fixation is a rare but serious event.We present a patient who developed pseudoaneurysm of profunda femoris artery after internal fixation of intertrochanteric fracture with a dynamic hip screw.The diagnosis was confirmed by angiographic study and it was successfully treated by coil embolization.

  14. Axillary Versus Femoral Arterial Cannulation During Repair of Type A Aortic Dissection?

    Science.gov (United States)

    Stamou, Sotiris C.; Gartner, Derek; Kouchoukos, Nicholas T.; Lobdell, Kevin W.; Khabbaz, Kamal; Murphy, Edward; Hagberg, Robert C.

    2016-01-01

    Background The goal of this study was to compare early postoperative outcomes and actuarial-free survival between patients who underwent repair of acute Type A aortic dissection with axillary or femoral artery cannulation. Methods A total of 305 patients from five academic medical centers underwent acute Type A aortic dissection repair via axillary (n = 107) or femoral (n = 198) artery cannulation between January 2000 and December 2010. Major morbidity, operative mortality, and 5-year actuarial survival were compared between groups. Multivariate logistic regression was used to determine predictors of operative mortality, and Cox regression hazard ratios were calculated to determine predictors of long-term mortality. Results Operative mortality was not influenced by cannulation site (16% for axillary cannulation vs. 19% for femoral cannulation, p = 0.64). In multivariate logistic regression analysis, hemodynamic instability (p 200 min; p = 0.05) emerged as independent predictors of operative mortality. Stroke rates were comparable between the two techniques (14% for axillary and 17% for femoral cannulation, p = 0.52). Five-year actuarial survival was comparable between the groups (55.1% for axillary and 65.7% for femoral cannulation, p = 0.36). In Cox regression analysis, predictors of long-term mortality were: age (p < 0.001), stroke (p < 0.001), prolonged cardiopulmonary bypass time (p = 0.001), hemodynamic instability (p = 0.002), and renal failure (p = 0.001). Conclusions The outcomes of femoral versus axillary arterial cannulation in patients with acute Type A aortic dissection are comparable. The choice of arterial cannulation site should be individualized based on different patient risk profiles. PMID:28097193

  15. S-nitrosothiols dilate the mesenteric artery more potently than the femoral artery by a cGMP and L-type calcium channel-dependent mechanism.

    Science.gov (United States)

    Liu, Taiming; Schroeder, Hobe J; Zhang, Meijuan; Wilson, Sean M; Terry, Michael H; Longo, Lawrence D; Power, Gordon G; Blood, Arlin B

    2016-08-31

    S-nitrosothiols (SNOs) are metabolites of NO with potent vasodilatory activity. Our previous studies in sheep indicated that intra-arterially infused SNOs dilate the mesenteric vasculature more than the femoral vasculature. We hypothesized that the mesenteric artery is more responsive to SNO-mediated vasodilation, and investigated various steps along the NO/cGMP pathway to determine the mechanism for this difference. In anesthetized adult sheep, we monitored the conductance of mesenteric and femoral arteries during infusion of S-nitroso-l-cysteine (L-cysNO), and found mesenteric vascular conductance increased (137 ± 3%) significantly more than femoral conductance (26 ± 25%). Similar results were found in wire myography studies of isolated sheep mesenteric and femoral arteries. Vasodilation by SNOs was attenuated in both vessel types by the presence of ODQ (sGC inhibitor), and both YC-1 (sGC agonist) and 8-Br-cGMP (cGMP analog) mediated more potent relaxation in mesenteric arteries than femoral arteries. The vasodilatory difference between mesenteric and femoral arteries was eliminated by antagonists of either protein kinase G or L-type Ca(2+) channels. Western immunoblots showed a larger L-type Ca(2+)/sGC abundance ratio in mesenteric arteries than in femoral arteries. Fetal sheep mesenteric arteries were more responsive to SNOs than adult mesenteric arteries, and had a greater L-Ca(2+)/sGC ratio (p = 0.047 and r = -0.906 for correlation between Emax and L-Ca(2+)/sGC). These results suggest that mesenteric arteries, especially those in fetus, are more responsive to SNO-mediated vasodilation than femoral arteries due to a greater role of the L-type calcium channel in the NO/cGMP pathway.

  16. A histological, ultrastructural and immunohistochemical study of superficial temporal arteries and middle meningeal arteries in moyamoya disease.

    Science.gov (United States)

    Li, B; Wang, C C; Zhao, Z Z; Hu, Y; Aihara, K; Ghazizadeh, M; Sasaki, Y; Yang, S Y; Pan, J

    1991-07-01

    Pathologic changes in superficial temporal arteries (STA) and middle meningeal arteries (MMA) biopsied from 15 patients with moyamoya disease (MD) who had undergone cerebro-temporal arterio-synangiosis were studied histologically, ultrastructurally and immunohistochemically. The main pathologic features were: proliferation of smooth muscle cells (SMCs) and thickening of the intima, degeneration and destruction of SMCs in the media and intima, and the presence of condensed organelles in necrosed SMCs or the interstitium among SMCs, or both outside and within the elastica interna (EI). The EI had become thin, porous, fragmented and was even absent in some segments. These changes are different from those of other forms of angiopathy, but identical with those at the ends of internal carotid arteries (ICA) reported by us previously, being pathognomonic for MD. These changes in the STA and MMA reveal that MD involves not only the ICA but also the intra- and extracranial branches of external carotid arteries. The medial necrosis of SMCs seems to be the primary injury of the arterial wall in MD. STA tissue blocks from two cases of MD were stained immunohistochemically. By electron microscopy, IgG-, IgM-, and C3-positive granules were observed on the ER of endothelial and intimal cells. Further studies on more cases are needed to determine whether an immunoreaction has occurred in these arteries.

  17. Malformação ílio-femoral Iliofemoral arterial malformation

    Directory of Open Access Journals (Sweden)

    Mangala M. Pai

    2006-12-01

    Full Text Available Durante uma dissecção de rotina realizada em um cadáver do sexo masculino com 65 anos de idade foi constatada malformação arterial iliofemoral. A aorta abdominal estava consideravelmente deslocada lateralmente e também bifurcava em nível mais alto. A artéria ilíaca comum dividia-se uma vértebra acima do nível normal e a artéria femoral dava origem à artéria femoral profunda aproximadamente l,2 cm abaixo do ligamento inguinal, o que é consideravelmente proximal ao seu nível normal. Aqui nós apresentamos uma breve revisão de literatura e base embriológica dessas anomalias.During routine dissection, an Iliofemoral arterial malformation was noticed in a 65 year old male cadaver. The abdominal aorta was considerably laterally displaced and also bifurcated higher up. The common iliac artery divided one vertebral level higher and the femoral artery gave the profunda femoris artery about 1.2 cm below the inguinal ligament, which is considerably proximal to its usual level of origin. A brief review of literature and embryological basis of the anomalies are discussed.

  18. Relative risk of aortic and femoral insertion of intraaortic balloon pump after coronary artery bypass grafting procedures.

    Science.gov (United States)

    Pinkard, J; Utley, J R; Leyland, S A; Morgan, M; Johnson, H

    1993-04-01

    We compared the preoperative, operative, and postoperative characteristics of patients who required balloon pumps after coronary artery bypass graft procedures to determine the relative risks of femoral and aortic insertion. The balloon pump was inserted into the ascending aorta when femoral insertion was not possible because of occlusive disease or small femoral arteries. Femoral insertion was performed in 81 patients and aortic insertion in 42 patients. Patients with aortic insertion were more likely to be small and female (p < 0.05) and were more likely to have carotid bruits and a history of strokes or transient ischemic attacks (p < 0.05). Death was more common in the patients with aortic insertion (18/42, 42.9%) than in those with femoral insertion (19/81, 23.4%) (p < 0.05), as calculated with single regression analysis. Route of insertion was not a predictor of operative death, according to multiple regression analysis. Leg complications were more common in patients with femoral artery insertion (23/81, 28.4%) than in those with aortic insertion (0/42, 0.0%) (p < 0.05). No sternal complications occurred in either group. New neurologic abnormalities were not significantly different between the patients with aortic and femoral insertion. Aortic insertion is a safe alternative to femoral insertion of intraaortic balloon pumps and is associated with fewer leg complications in small or diseased iliac and femoral arteries. The greater mortality rate with aortic insertion is related to greater comorbidity rate in these patients.

  19. Effects of Crimping on Mechanical Performance of Nitinol Stent Designed for Femoral Artery: Finite Element Analysis

    Science.gov (United States)

    Nematzadeh, F.; Sadrnezhaad, S. K.

    2013-11-01

    Nitinol stents are used to minimize improper dynamic behavior, low twistability, and inadequate radial mechanical strength of femoral artery stents. In this study, finite element method is used to investigate the effect of crimping and Austenite finish temperature ( A f) of Nitinol on mechanical performance of Z-shaped open-cell femoral stent under crimping conditions. Results show that low A f Nitinol has better mechanical and clinical performance due to small chronic outward force, large radial resistive force, and appropriate superelastic behavior.

  20. A new method to catheterize a femoral artery in mice using a nylon suture as a 'guide wire'.

    Science.gov (United States)

    Fukui, S; Nawshiro, H; Wada, K; Shima, K; Hallenbeck, J M

    2001-09-01

    Mice are commonly used in laboratory experiments. Their femoral arteries are so tiny that catheterization is quite difficult. We describe a new method to catheterize the femoral artery in mice. The key feature of this new method is the use of a nylon suture as a 'guide wire'. The full catheterization system consists of two sizes of polyethylene tubes (PE-10, PE-50) and a 4-0 nylon suture. We have been able to repeatedly catheterize mouse femoral arteries (n = 57) successfully and easily with this new system. We believe that this new method can facilitate vascular catheterization in small animals such as mice.

  1. Intra-operative Hemostasis of Punctured Femoral Artery Using HIFU: A Survival Study

    Science.gov (United States)

    Zderic, Vesna; Keshavarzi, Amid; Noble, Misty L.; Paun, Marla; Sharar, Sam R.; Crum, Lawrence A.; Martin, Roy W.; Vaezy, Shahram

    2005-03-01

    The objective was to investigate the long-term efficacy of hemostasis and healing of arteries after HIFU application. The femoral arteries of 22 adult rabbits were surgically exposed. Fifteen arteries were punctured with a needle and treated with HIFU, and 7 arteries were sham-treated (no puncture or HIFU was applied). The tip of the HIFU applicator was positioned on the bleeding site, and HIFU energy was applied until hemostasis was achieved. The focal intensity was approximately 3,000 W/cm2, at the resonant frequency of 9.6 MHz. Serial ultrasound images, blood and tissue samples were collected immediately and on days 1, 3, 7, 14, 28, and 60 after the treatment. Eleven of the arteries were patent after the treatment, and four arteries were occluded, as confirmed using Doppler imaging. One of the occluded arteries reopened at day 14. HIFU exposure time to achieve hemostasis was 27 ±17 seconds for patent arteries and 101±38 seconds for the occluded arteries. The blood flow velocities were not statistically different between HIFU-treated patent vessels and sham-treated vessels. The tunica adventitia and media, disrupted and coagulated immediately after the treatment, recovered to normal appearance within 28 days, with localized thinning of the tunica media observed up to day 60. Neo-intimal hyperplasia was observed in the arteries at days 14 and 28. HIFU produced an effective and long-term (up to 60 days) hemostasis of injured femoral arteries while preserving a normal blood flow and vessel wall structure in the majority of vessels.

  2. Femoral Artery Atherosclerosis Is Associated With Physical Function Across the Spectrum of the Ankle-Brachial Index: The San Diego Population Study.

    Science.gov (United States)

    Wassel, Christina L; Ellis, Alicia M; Suder, Natalie C; Barinas-Mitchell, Emma; Rifkin, Dena E; Forbang, Nketi I; Denenberg, Julie O; Marasco, Antoinette M; McQuaide, Belinda J; Jenny, Nancy S; Allison, Matthew A; Ix, Joachim H; Criqui, Michael H

    2017-07-20

    The ankle-brachial index (ABI) is inadequate to detect early-stage atherosclerotic disease, when interventions to prevent functional decline may be the most effective. We determined associations of femoral artery atherosclerosis with physical functioning, across the spectrum of the ABI, and within the normal ABI range. In 2007-2011, 1103 multiethnic men and women participated in the San Diego Population Study, and completed all components of the summary performance score. Using Doppler ultrasound, superficial and common femoral intima media thickness and plaques were ascertained. Logistic regression was used to assess associations of femoral atherosclerosis with the summary performance score and its individual components. Models were adjusted for demographics, lifestyle factors, comorbidities, lipids, and kidney function. In adjusted models, among participants with a normal-range ABI (1.00-1.30), the highest tertile of superficial intima media thickness was associated with lower odds of a perfect summary performance score of 12 (odds ratio=0.56 [0.36, 0.87], P=0.009), and lower odds of a 4-m walk score of 4 (0.34 [0.16, 0.73], P=0.006) and chair rise score of 4 (0.56 [0.34, 0.94], P=0.03). Plaque presence (0.53 [0.29, 0.99], P=0.04) and greater total plaque burden (0.61 [0.43, 0.87], P=0.006) were associated with worse 4-m walk performance in the normal-range ABI group. Higher superficial intima media thickness was associated with lower summary performance score in all individuals (P=0.02). Findings suggest that use of femoral artery atherosclerosis measures may be effective in individuals with a normal-range ABI, especially, for example, those with diabetes mellitus or a family history of peripheral artery disease, when detection can lead to earlier intervention to prevent functional declines and improve quality of life. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  3. Local Sympathetic Denervation of Femoral Artery in a Rabbit Model by Using 6-Hydroxydopamine In Situ

    Directory of Open Access Journals (Sweden)

    Yufei Jin

    2014-01-01

    Full Text Available Both artery bundle and sympathetic nerve were involved with the metabolism of bone tissues. Whether the enhancing effects of artery bundle result from its accompanying sympathetic nerve or blood supply is still unknown. There is no ideal sympathetic nerve-inhibited method for the in situ denervation of artery bundle. Therefore, we dipped the femoral artery in the 6-hydroxydopamine (6-OHDA locally and observed its effect. Compared with control group, the in situ treatment of 6-OHDA did not damage the normal structure of vascular bundle indicated by hematoxylin-eosin (HE staining. However, the functions of sympathetic nerve was completely inhibited for more than 2 weeks, and only a few function of sympathetic nerve resumed 4 weeks later, evidenced by glyoxylic acid staining and the expression of tyrosine hydroxylase (TH and nerve peptide Y (NPY. Thus, 6-OHDA is promising as an ideal reagent for the local denervation of sympathetic nerve from artery system.

  4. CT perfusion assessment of Moyamoya syndrome before and after direct revascularization (superficial temporal artery to middle cerebral artery bypass)

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Yueqin [Hospital of Qingdao University, Department of Radiology, Qingdao (China); Hospital of Jining Medical College, CT Department, Jining (China); Xu, Wenjian [Hospital of Qingdao University, Department of Radiology, Qingdao (China); Guo, Xiang; Shi, Zhitao; Sun, Zhanguo; Wang, Jiehuan [Hospital of Jining Medical College, CT Department, Jining (China); Gao, Lingyun [Hospital of Jining Medical College, MR Department, Jining (China); Jin, Feng [Hospital of Jining Medical College, Department of Neurosurgery, Jining (China); Chen, Weijian; Yang, Yunjun [Hospital of Wenzhou Medical University, Department of Radiology, Wenzhou (China)

    2016-01-15

    To evaluate the utility of CT perfusion (CTP) for the assessment of superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis in patients with Moyamoya syndrome (MMS). Twenty-four consecutive MMS patients, who underwent unilateral STA-MCA bypass surgery, received CTP before and after surgery. The relative perfusion parameter values of surgical hemispheres before treatment were compared with post-treatment values. All patients underwent CT angiography (CTA) before and after surgery in order to confirm the patency of bypass. The follow-up CTA after surgery clearly demonstrated 20 (20/24, 83.3 %) bypass arteries, whereas four (16.7 %) bypass arteries were occluded or very small. Postoperative rMTT and rTTP values (P < 0.05) of the surgical side were significantly lower than pre-operation. In patients (n = 20) with bypass patency, postoperative rCBF, rMTT and rTTP values (P < 0.05) of the surgical side were significantly improved. However, the differences of all parameters were not significant (P > 0.05) in the patients (n = 4) without bypass patency after revascularization. This study demonstrates that CTP can provide a crucial quantitative assessment of cerebral haemodynamic changes in MMS before and after STA-MCA anastomosis. (orig.)

  5. Biphasic threat to femoral head perfusion in abduction: arterial hypoperfusion and venous congestion

    Energy Technology Data Exchange (ETDEWEB)

    Yousefzadeh, David K. [Comer Children' s Hospital, Department of Radiology, Chicago, IL (United States); University of Chicago, Department of Radiology, Chicago, IL (United States); Jaramillo, Diego [Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Johnson, Neil [Cincinnati Children' s Hospital, Department of Radiology, Cincinnati, OH (United States); Doerger, Kirk [Radiology Associates of Northern Kentucky, Crestview Hills, KY (United States); Sullivan, Christopher [University of Chicago, Department of Surgery, Chicago, IL (United States)

    2010-09-15

    Hip abduction can cause avascular necrosis (AVN) of the femoral head in infants. To compare the US perfusion pattern of femoral head cartilage in neutral position with that in different degrees and duration of abduction, testing the venous congestion theory of post-abduction ischemia. In 20 neonates, the Doppler flow characteristics of the posterosuperior (PS) branch of the femoral head cartilage feeding vessels were evaluated in neutral and at 30 , 45 , and 60 abduction. In three neonates the leg was held in 45-degree abduction and flow was assessed at 5, 10, and 15 min. Male/female ratio was 11/9 with a mean age of 1.86 {+-} 0.7 weeks. The peak systolic velocities (PSV) declined in all three degrees of abduction. After 15 min of 45-degree abduction, the mean PSV declined and showed an absent or reversed diastolic component and undetectable venous return. No perfusion was detected at 60-degree abduction. Abduction-induced femoral head ischemia is biphasic and degree- and duration-dependent. In phase I there is arterial hypoperfusion and in phase II there is venous congestion. A new pathogeneses for femoral head ischemia is offered. (orig.)

  6. Effect of arterial deprivation on growing femoral epiphysis: Quantitative magnetic resonance imaging using a piglet model

    Energy Technology Data Exchange (ETDEWEB)

    Cheon, Jung Eun; Yoo, Won Joon; Kim, In One; Kim, Woo Sun; Choi, Young Hun [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2015-06-15

    To investigate the usefulness of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion MRI for the evaluation of femoral head ischemia. Unilateral femoral head ischemia was induced by selective embolization of the medial circumflex femoral artery in 10 piglets. All MRIs were performed immediately (1 hour) and after embolization (1, 2, and 4 weeks). Apparent diffusion coefficients (ADCs) were calculated for the femoral head. The estimated pharmacokinetic parameters (Kep and Ve from two-compartment model) and semi-quantitative parameters including peak enhancement, time-to-peak (TTP), and contrast washout were evaluated. The epiphyseal ADC values of the ischemic hip decreased immediately (1 hour) after embolization. However, they increased rapidly at 1 week after embolization and remained elevated until 4 weeks after embolization. Perfusion MRI of ischemic hips showed decreased epiphyseal perfusion with decreased Kep immediately after embolization. Signal intensity-time curves showed delayed TTP with limited contrast washout immediately post-embolization. At 1-2 weeks after embolization, spontaneous reperfusion was observed in ischemic epiphyses. The change of ADC (p = 0.043) and Kep (p = 0.043) were significantly different between immediate (1 hour) after embolization and 1 week post-embolization. Diffusion MRI and pharmacokinetic model obtained from the DCE-MRI are useful in depicting early changes of perfusion and tissue damage using the model of femoral head ischemia in skeletally immature piglets.

  7. Is there already a place for endovascular treatment of the common femoral artery?

    Science.gov (United States)

    Geiger, M; Deloose, K; Callaert, J; Bosiers, M

    2015-02-01

    Surgical endarterectomy has been considered the prefered technique for treating the common femoral artery (CFA). Although favorable endovascular treatment results of the CFA have recently become available, losing the groin area as an important acess site is still the major concern for this technique to become the golden standart. Nevertheless, the endovascular approach has shown, through several studies, including our experience, the capacity to establish itself as a complementery treatment for the modern vascular surgeon.

  8. Vascular complications following therapeutic and diagnostic cardiac catheterisation by the femoral artery

    DEFF Research Database (Denmark)

    Bitsch, M; Liisberg-Larsen, Ole Christian; Schroeder, T V

    1994-01-01

    Twenty-one of 6327 (0.33%) patients undergoing cardiac catheterisation via the femoral artery had an acute vascular complication requiring surgical intervention. The complication rate was 0.1% after coronary angiography, 2% after PTCA and 6% after aortic ballon dilatation. The size of the cathete...... and evaluation of vascular injuries following diagnostic and therapeutic invasive interventions could have a self limitating effect on the complication rate....

  9. Sympathetic vasomotor control does not explain the change in femoral artery shear rate pattern during arm-crank exercise.

    Science.gov (United States)

    Thijssen, Dick H J; Green, Daniel J; Steendijk, Sjoerd; Hopman, Maria T E

    2009-01-01

    During lower limb exercise, blood flow through the resting upper limbs exhibits a change characterized by increased anterograde flow during systole, but also large increases in retrograde diastolic flow. One explanation for the retrograde flow is that increased sympathetic nervous system (SNS) tone and concomitant increased peripheral resistance generate a rebound during diastole. To examine whether the SNS contributes to retrograde flow patterns, we measured femoral artery blood flow during arm-crank exercise in 10 healthy men (31 +/- 4 yr) and 10 spinal cord-injured (SCI) subjects who lack sympathetic innervation in the legs (33 +/- 5 yr). Before, and every 5 min during 25-min arm-crank exercise at 50% maximal capacity, femoral artery blood flow and peak anterograde and retrograde shear rate were assessed using echo Doppler sonography. Femoral artery baseline blood flow was significantly lower in SCI compared with controls. Exercise increased femoral artery blood flow in both groups (ANOVA, P change during exercise in either group. Mean shear rate was lower in SCI than in controls (P rate was higher in SCI than in controls (P rate did not differ between groups. Arm-crank exercise induced an increase in peak anterograde and retrograde shear rate in the femoral artery in controls and SCI subjects (P change the flow pattern in inactive regions during exercise. Local mechanisms may play a role in the arm-crank exercise-induced changes in flow pattern in the femoral artery.

  10. Experimental investigations of the steady flow through an idealized model of a femoral artery bypass

    Directory of Open Access Journals (Sweden)

    Giurgea Corina

    2014-03-01

    Full Text Available The present paper presents the steps taken by the authors in the first stage of an experimental program within a larger national research project whose objective is to characterize the flow through a femoral artery bypass with a view to finding solutions for its optimization. The objective of the stage is to investigate by means of the PIV method the stationary flow through a bypass model with an idealized geometry. A bypass assembly which reunites the idealized geometry models of the proximal and distal anastomoses, and which respects the lengths of a femoral artery bypass was constructed on the basis of data for a real patient provided by medical investigations. With the aim of testing the model and the established experimental set-up with regard to their suitability for the assessment of the velocity field associated to the steady flow through the bypass, three zones that can restore the whole distal anastomosis were PIV investigated. The measurements were taken in the conditions of maintained inflow at the bypass entry of 0.9 l / min (Re = 600. The article presents comparatively the flow spectra and the velocity fields for each zone obtained in two situations: with the femoral artery completely occluded and completely open.

  11. [A mathematical analysis of the flow-velocity curves in the femoral arteries].

    Science.gov (United States)

    Ley Pozo, J; Vega Gómez, M E; Aldama Figueroa, A; Ochoa Bizet, M

    1993-01-01

    In order to improve the early diagnosis of the aortoiliac injuries, 98 arteries from several supposedly health patients (different ages) and 41 femoral arteries from patients with occlusion at this level (demonstrated by arteriography) were studied. The analysis from the Fourier's series showed highly significant differences between both groups, and so did the comparison of some indexes automatically measured by the Vasoscan VL equip. By multivariant statistics methods was selected the main group of parameters that allows the differentiation between the ill patients and the healthy ones. This procedure can be useful for the physiopathological study and it may be used as a non-invasive method of diagnosis.

  12. Bilateral True Giant Aneurysm of the Profunda Femoral Artery: Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Alessandro Robaldo

    2012-01-01

    Full Text Available We report a rare case of a bilateral true giant aneurysm of the profunda femoral artery aneurysms (PFAAs in a 80-year-old man with a previous history of “open” abdominal aortic surgery and small bilateral popliteal artery aneurysm. In the English Literature only seven previously cases of true bilateral PFAAs are reported. Due to its location, this lesion may require surgical intervention and removal. The presentation, the diagnostic evaluation, and the surgical management of the aneurysm are discussed.

  13. Evaluation of a pig femoral head osteonecrosis model

    Directory of Open Access Journals (Sweden)

    Kim Harry

    2010-03-01

    Full Text Available Abstract Background A major cause of osteonecrosis of the femoral head is interruption of a blood supply to the proximal femur. In order to evaluate blood circulation and pathogenetic alterations, a pig femoral head osteonecrosis model was examined to address whether ligature of the femoral neck (vasculature deprivation induces a reduction of blood circulation in the femoral head, and whether transphyseal vessels exist for communications between the epiphysis and the metaphysis. We also tested the hypothesis that the vessels surrounding the femoral neck and the ligamentum teres represent the primary source of blood flow to the femoral head. Methods Avascular osteonecrosis of the femoral head was induced in Yorkshire pigs by transecting the ligamentum teres and placing two ligatures around the femoral neck. After heparinized saline infusion and microfil perfusion via the abdominal aorta, blood circulation in the femoral head was evaluated by optical and CT imaging. Results An angiogram of the microfil casted sample allowed identification of the major blood vessels to the proximal femur including the iliac, common femoral, superficial femoral, deep femoral and circumflex arteries. Optical imaging in the femoral neck showed that a microfil stained vessel network was visible in control sections but less noticeable in necrotic sections. CT images showed a lack of microfil staining in the epiphysis. Furthermore, no transphyseal vessels were observed to link the epiphysis to the metaphysis. Conclusion Optical and CT imaging analyses revealed that in this present pig model the ligatures around the femoral neck were the primary cause of induction of avascular osteonecrosis. Since the vessels surrounding the femoral neck are comprised of the branches of the medial and the lateral femoral circumflex vessels, together with the extracapsular arterial ring and the lateral epiphyseal arteries, augmentation of blood circulation in those arteries will improve

  14. Superficial temporal artery-middle cerebral artery bypass combined with encephalo-duro-myo-synangiosis in treating moyamoya disease: surgical techniques, indications and midterm follow-up results

    Institute of Scientific and Technical Information of China (English)

    XU Bin; SONG Dong-lei; MAO Ying; GU Yu-xiang; XU Hong; LIAO Yu-jun; LIU Chuang-hong; ZHOU Liang-fu

    2012-01-01

    Background Surgical interventions for moyamoya disease include direct and indirect revascularizations.This study aimed to evaluate the therapeutic effect of superficial temporal artery-middle cerebral artery bypass combined with an indirect revascularization procedure,encephalo-duro-myo-synangiosis,in the treatment of moyamoya disease.Methods From October 2005 to November 2009,we performed this combined revascularization procedure in 111 patients with different types and stages of moyamoya disease.The superficial temporal artery,middle meningeal artery and the deep temporal artery were evaluated for individualized surgical planning in these cases.The integrity of the deep temporal artery and the middle meningeal artery network,and the pre-existing spontaneous anastomoses of the distal branches of the external carotid artery with the cortical arteries were well preserved.The mean follow-up time was 72.5 months,all clinical and radiological data were retrospectively reviewed.Results A total of 198 stomas were performed in 122 hemispheres,all remaining patent until the last follow-up.The encephalo-duro-myo-synangiosis resulted in extensive anastomoses of the deep temporal artery (100%),the middle meningeal artery (90.9%),and the sphenopalatine artery (39.8%) with the cortical arteries,respectitvely.The superficial temporal artery,deep temporal artery,and the middle meningeal artery were significantly thickened in 88 patients as determined by digital subtraction angiography at follow-up.The relative cerebral blood flow increased significantly within one week after the operation.At 6 months post the operation,the relative cerebral blood flow was further increased by 15.5% from the gradual formation of anastomoses as a result of indirect revascularization.Transient ischemic attacks were effectively reduced or totally arrested.The neurological deficits significantly improved in 37 patients,with the National Institutes of Health Stroke Scale scores lowered by 2

  15. Constriction of collateral arteries induced by "head-up tilt" in patients with occlusive arterial disease of the legs

    DEFF Research Database (Denmark)

    Agerskov, K; Henriksen, O; Tønnesen, K H

    1981-01-01

    . Relative change in blood flow in the leg during tilt was estimated by changes in arterio-venous oxygen differences and by the indicator dilution technique in nine patients. Head-up tilt caused a decrease in leg blood flow of 36% corresponding to an increase in total vascular resistance of 57%. Tilt did......The effect of head-up tilt on leg blood flow and segmental arterial blood pressures was studied in 21 patients with occlusion or severe stenosis of the common or superficial femoral artery. Arterial pressure was measured directly in the brachial artery, common femoral artery and popliteal artery...... not change the pressure gradient from femoral to popliteal artery in the patients with occlusion of the superficial femoral artery, indicating that the flow resistance offered by the collateral arteries had increased. In a bilateral sympathectomised patient the increase in collateral resistance was almost...

  16. Distinct Differences on Neointima Formation in Immunodeficient and Humanized Mice after Carotid or Femoral Arterial Injury

    Science.gov (United States)

    Moser, Jill; van Ark, Joris; van Dijk, Marcory C.; Greiner, Dale L.; Shultz, Leonard D.; van Goor, Harry; Hillebrands, Jan-Luuk

    2016-01-01

    Percutaneous coronary intervention is widely adopted to treat patients with coronary artery disease. However, restenosis remains an unsolved clinical problem after vascular interventions. The role of the systemic and local immune response in the development of restenosis is not fully understood. Hence, the aim of the current study was to investigate the role of the human immune system on subsequent neointima formation elicited by vascular injury in a humanized mouse model. Immunodeficient NOD.Cg-PrkdcscidIL2rgtm1Wjl(NSG) mice were reconstituted with human (h)PBMCs immediately after both carotid wire and femoral cuff injury were induced in order to identify how differences in the severity of injury influenced endothelial regeneration, neointima formation, and homing of human inflammatory and progenitor cells. In contrast to non-reconstituted mice, hPBMC reconstitution reduced neointima formation after femoral cuff injury whereas hPBMCs promoted neointima formation after carotid wire injury 4 weeks after induction of injury. Neointimal endothelium and smooth muscle cells in the injured arteries were of mouse origin. Our results indicate that the immune system may differentially respond to arterial injury depending on the severity of injury, which may also be influenced by the intrinsic properties of the arteries themselves, resulting in either minimal or aggravated neointima formation. PMID:27759053

  17. An impedance matching of femoral-popliteal arterial grafts: a theoretical study.

    Science.gov (United States)

    Hirayama, H; Nishimura, T; Fukuyama, Y

    1997-05-01

    We have proposed a mathematical method to investigate the matching conditions for an arterial graft in the femoral-popliteal region from a mechanical stand-point. Pulsatory blood flow, arterial wall motions, and conservation law are expressed by linear dynamical equations based on strict mechanical and constitutional considerations. To express the physiological blood flow in an actual arterial system, the tethering effects from the surrounding tissue and wall tensions were incorporated. The physiological parameters of arterial wall and tethering were utilized from reported experimental data. By complex analysis, mathematical expressions for the local impedance and reflection coefficient were obtained. They include not only blood properties such as viscosity and density, but also arterial properties including elastic modulus, radius, Poisson ratio, wall thickness, wall tension, frequency, and tethering effects from surrounding tissue. A matching condition was defined for minimizing the local impedance and reflection coefficient. The biophysical background was to reduce any mechanical mismatches, thus minimizing the disturbance of the flow velocity profile and shear stress distribution within the artery. Impedance matching in turn diminishes the negative factors for graft substitution represented by intimal hyperplasia and thrombosis. The calculated impedance and reflection coefficient inversed parabolically to functions of the resistance of the host artery, and there was one host arterial resistance that minimized the impedance and reflection coefficient. The present analysis revealed that for matching host artery with an elevated resistance, the dynamic elastic modulus of the wall of the graft that minimizes the impedance and reflection coefficient was increased. This indicates that for a host artery with a high resistance, an impedance matched stiff wall graft is preferable. For a large radius and a compliant host artery on the other hand, a large compliant graft

  18. Partial breast reconstruction with mini superficial inferior epigastric artery and mini deep inferior epigastric perforator flaps.

    Science.gov (United States)

    Spiegel, Aldona J; Eldor, Liron

    2010-08-01

    In this study, partial breast reconstruction was undertaken after breast conservation therapy using mini abdominal free flaps on both an immediate and delayed basis.Patient demographics, oncologic status, reconstructive data, and complications were collected from medical records.Twelve patients (age range 39-60) were included in this study with a mean follow-up time of 5 years. Ten mini superficial inferior epigastric artery flaps and 2 mini deep inferior epigastric perforator flaps were used (7 immediate and 5 delayed reconstructions). No flap lost, 1 minor abdominal wound dehiscence, and no local or distant recurrences were noted. Good to excellent results were reported by 91% of the women.In properly selected patients with high motivation toward breast conservation, tailored abdominal mini-free flaps can safely and satisfactorily be implemented for the reconstruction of partial mastectomy defects. Patients should be comprehensively educated on the potential future implications of using the abdominal donor site for partial breast reconstruction.

  19. Hybrid approach to limb salvage in the setting of an infected femoral-femoral bypass graft.

    Science.gov (United States)

    Jones, Douglas W; Meltzer, Andrew J; Schneider, Darren B

    2014-08-01

    Prosthetic vascular graft infection in patients with advanced peripheral arterial disease can lead to multiple additional procedures, including extra-anatomic bypass or even amputation. We report the case of an 88-year-old woman with critical limb ischemia and an infected prosthetic femoral-femoral bypass graft. Using a planned hybrid 2-stage approach, we performed endovascular recanalization of the native left iliac arterial system using remote access via the superficial femoral artery to avoid infected groin wounds. Recanalization of the patient's Trans-Atlantic Inter-Society Consensus II D chronic iliac occlusion allowed for removal of the infected graft and placement of a profunda femoris artery to proximal posterior tibial artery bypass, thereby restoring inflow and avoiding the infected left groin. Newer endovascular techniques coupled with open surgical options may lead to limb salvage in patients with previously unreconstructable peripheral arterial disease.

  20. Blackcurrant Alters Physiological Responses and Femoral Artery Diameter during Sustained Isometric Contraction

    Directory of Open Access Journals (Sweden)

    Matthew David Cook

    2017-05-01

    Full Text Available Blackcurrant is rich in anthocyanins that may affect exercise-induced physiological responses. We examined tissue oxygen saturation, muscle activity, cardiovascular responses and femoral artery diameter during a submaximal sustained isometric contraction. In a randomised, double-blind, crossover design, healthy men (n = 13, age: 25 ± 4 years, BMI: 25 ± 3 kg·m−2, mean ± SD ingested New Zealand blackcurrant (NZBC extract (600 mg∙day−1 CurraNZ™ or placebo (PL for 7-days separated by 14-days washout. Participants produced isometric maximal voluntary contractions (iMVC and a 120-s 30%iMVC of the quadriceps with electromyography (EMG, near-infrared spectroscopy, hemodynamic and ultrasound recordings. There was no effect of NZBC extract on iMVC (NZBC: 654 ± 73, PL: 650 ± 78 N. During the 30%iMVC with NZBC extract, total peripheral resistance, systolic, diastolic, and mean arterial pressure were lower with increased cardiac output and stroke volume. With NZBC extract, EMG root mean square of the vastus medialis and muscle oxygen saturation were lower with higher total haemoglobin. During the 30%iMVC, femoral artery diameter was increased with NZBC extract at 30 (6.9%, 60 (8.2%, 90 (7.7% and 120 s (6.0%. Intake of NZBC extract for 7-days altered cardiovascular responses, muscle oxygen saturation, muscle activity and femoral artery diameter during a 120-s 30%iMVC of the quadriceps. The present study provides insight into the potential mechanisms for enhanced exercise performance with intake of blackcurrant.

  1. Posterior Wall Capture and Femoral Artery Stenosis Following Use of StarClose Closing Device: Diagnosis and Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Stefanczyk, Ludomir [Medical University of Lodz, First Department of Radiology and Diagnostic Imaging (Poland); Elgalal, Marcin T., E-mail: telgalal@yahoo.co.uk [Medical University of Lodz, Second Department of Radiology and Diagnostic Imaging (Poland); Szubert, Wojciech; Grzelak, Piotr [Medical University of Lodz, First Department of Radiology and Diagnostic Imaging (Poland); Szopinski, Piotr [Institute of Haematology and Transfusion Medicine, Department of Vascular Surgery (Poland); Majos, Agata [Medical University of Lodz, Second Department of Radiology and Diagnostic Imaging (Poland)

    2013-10-15

    A case of femoral artery obstruction following application of a StarClose type arterial puncture closing device (APCD) is presented. Ultrasonographic and angiographic imaging of this complication was obtained. The posterior wall of the vessel was accidentally caught in the anchoring element of the nitinol clip. This complication was successfully resolved by endovascular treatment and the implantation of a stent.

  2. Iatrogenic injuries of the common femoral artery (CFA) and external iliac artery (EIA) during endograft placement: an underdiagnosed entity.

    Science.gov (United States)

    Hingorani, Anil P; Ascher, Enrico; Marks, Natalie; Shiferson, Alexander; Patel, Nirav; Gopal, Kapil; Jacob, Theresa

    2009-09-01

    Early limb occlusions following endovascular treatment of aorto-iliac aneurysmal disease is not uncommon (4%-13%). To assess whether the femoral artery entry site could potentially cause this complication, we prospectively evaluated the ipsilateral common femoral artery (CFA) and distal external iliac artery (EIA) with intraoperative duplex scans (IDS). There were 134 patients with infrarenal nonruptured abdominal aorto-iliac aneurysms treated with endografts since 2002 at our institution. Age ranged from 65 to 89 years (mean: 77 +/- 7 years). Aneuryx (n = 41), Zenith (n = 50), and Excluder (n = 43) endografts were used for repair. All procedures were performed via open exposure of the CFA. Introducer diameter varied from 12 mm to 22 mm. All patients underwent IDS of the CFA and distal EIA after repair of the arteriotomies. In 34 patients (25%), we documented intimal dissections causing severe (>70%) stenoses. Of the 271 arteries that were examined, 38 (14%) had abnormal findings that demanded intervention. These were repaired with flap excision, tacking sutures revision, or patch angioplasty (n = 36). Repeat IDS confirmed the adequacy of the repair. No statistical difference was noted if the site of larger introducer sheath and the incidence of flap formation. In addition, 10 small flaps or plaques were visualized but did not create significant stenosis. No differences were noted in the incidence of positive duplex exams between each type graft (P = .4). No early or late iliac limb occlusions were noted. Follow-up of 94% was obtained. Completion arterial duplex scans are helpful in detecting a substantial number of clinically unsuspected technical defects caused by introducer sheaths. Timely diagnosis and repair of these defects may decrease the incidence of early limb occlusion following endograft placement.

  3. High origin of the deep femoral artery: a case report and literature review Origem alta da artéria femoral profunda: relato de caso e revisão da literatura

    Directory of Open Access Journals (Sweden)

    Vishal Kumar

    2011-09-01

    Full Text Available Arterial variations of the femoral triangle are rarely reported in the literature. In the present article, we have reported a case of high origin of the deep femoral artery, which was originating just lower to the inguinal ligament. It was also observed that the lateral circumflex femoral artery arose directly from the femoral artery instead from the deep femoral artery. We have discussed the anatomy, embryological basis, and clinical implications of these variations along with relevant literature review. The importance of knowledge about these variations in therapeutic and diagnostic interventions is discussed.Variações arteriais no triângulo femoral têm sido pouco relatadas na literatura. No presente artigo, relatou-se um caso de origem alta da artéria femoral profunda, que estava se originando pouco abaixo do ligamento inguinal. Também foi observado que a artéria femoral circunflexa originava-se diretamente da artéria femoral, ao invés de ser originada da artéria femoral profunda. Discutiu-se sobre anatomia, base embriológica e implicações clínicas dessas variações junto com uma revisão da literatura pertinente. A importância do conhecimento sobre essas variações no quadro das intervenções diagnósticas e terapêuticas é discutida.

  4. Malformação ílio-femoral Iliofemoral arterial malformation

    OpenAIRE

    2006-01-01

    Durante uma dissecção de rotina realizada em um cadáver do sexo masculino com 65 anos de idade foi constatada malformação arterial iliofemoral. A aorta abdominal estava consideravelmente deslocada lateralmente e também bifurcava em nível mais alto. A artéria ilíaca comum dividia-se uma vértebra acima do nível normal e a artéria femoral dava origem à artéria femoral profunda aproximadamente l,2 cm abaixo do ligamento inguinal, o que é consideravelmente proximal ao seu nível normal. Aqui nós ap...

  5. Emergency Percutaneous Coronary Intervention Through the Left Radial Artery is Associated with Less Vascular Complications than Emergency Percutaneous Coronary Intervention Through the Femoral Artery.

    Science.gov (United States)

    Qi, Guoqing; Sun, Qi; Xia, Yue; Wei, Liye

    2017-01-01

    To compare the advantages and disadvantages of emergency percutaneous coronary intervention through the left radial artery with those of emergency percutaneous coronary intervention through the femoral artery. A total of 206 patients with acute myocardial infarction who required emergency percutaneous coronary intervention and were admitted to our hospital between January 2011 and August 2013 were divided into the following two groups: a group that underwent percutaneous coronary intervention through the left radial artery and a group that underwent percutaneous coronary intervention through the femoral artery. The times required for angiographic catheter and guiding catheter placement, the success rate of the procedure and the incidence of vascular complications in the two groups were observed. There was no significant difference in catheter placement time or the ultimate success rate of the procedure between the two groups. However, the left radial artery group showed a significantly lower incidence of vascular complications than the femoral artery group (pEmergency percutaneous coronary intervention through the left radial artery is associated with less vascular complications than emergency percutaneous coronary intervention through the femoral artery and is thus potentially advantageous for patients.

  6. Laceration of femoral vessels by an avulsion fracture fragment of the lesser trochanter after bipolar hemiarthroplasty.

    Science.gov (United States)

    Ha, Yong-Chan; Luminita, Simion; Cho, Se-Hyun; Choi, Jun-Young; Koo, Kyung-Hoi

    2005-08-01

    Femoral vessel injuries after bipolar hemiarthroplasty have not been reported. The current report describes a case of a dual major vessel (superficial femoral artery and vein) injury associated with an avulsion fracture fragment of the lesser trochanter in a 76-year-old woman who had been treated with bipolar hemiarthroplasty because of a femoral neck fracture. The superficial femoral artery was repaired and the defect of the superficial femoral vein was reconstructed with a Gore-Tex graft (WL Gore and Associates Inc, Flagstaff, Ariz). The clinical result was satisfactory and there was no vascular problem at 1-year follow-up. Early diagnosis of this vascular injury prevents serious complications including gangrene of the injured limb.

  7. [Hematoma of the abdominal wall. A case report: pitfall of Seldinger method via femoral artery].

    Science.gov (United States)

    Hiramatsu, Hisaya; Sugiura, Yasushi; Takeda, Ririko; Nanba, Hiroki

    2009-02-01

    We reported a case of an abdominal wall hematoma which caused by Seldinger method via the femoral artery. A 48-year-old female, suffered from direct carotid cavernous fistula, was treated by transfemoral transvenous embolization (TVE). The whole procedure was completed without difficulty except minor resistance of guide wire manipulation during left femoral artery catheterization. Four hours later, the patient became hypotensive and showed the sign of impending shock without definitive causes. Nine hours after the embolization a huge hematoma of the abdominal wall was found. It required the total 1200 m/ of blood transfusion before her blood pressure returned to normal. She recovered fully from this event and discharged uneventfully. There is a speculation that a deep circumflex iliac artery (DCIA) was injured with an angle-shaped guide wire and bled into the abdominal wall. And subsequent systemic heparinization prevented the coagulation process, resulting a large hematoma. Anatomically, an angle-shaped guide wire is easily able to migrate into DCIA. To prevent a vascular injury, it is very important to manipulate a guide wire under fluoroscopic control and to select a J-shaped guide wire instead of an angle-shaped one.

  8. Catecholamines in plasma from artery, cubital vein, and femoral vein in patients with cirrhosis. Significance of sampling site

    DEFF Research Database (Denmark)

    Henriksen, J H; Ring-Larsen, H; Christensen, N J

    1986-01-01

    The concentration of noradrenaline (NA) and adrenaline (A) was measured in arterial, cubital venous and femoral venous plasma in order to determine possible differences in different vascular beds in the peripheral circulation. In patients with cirrhosis, arterial plasma NA (median 2.54 nmol/l, n ...... the skin of forearm and hand). To assess circulating levels of catecholamines, the importance of arterial sampling is stressed as peripheral venous samples may also reflect local factors....

  9. Surgical management of infected pseudoaneurysms of femoral artery caused by narcotics injection%注射毒品致股动脉感染性假性动脉瘤的外科治疗

    Institute of Scientific and Technical Information of China (English)

    李全明; 舒畅; 姜晓华; 黎明; 李鑫; 何昊

    2009-01-01

    目的:探讨注射毒品致股动脉感染性假性动脉瘤的外科治疗.方法:回顾性分析因注射毒品致股动脉感染性假性动脉瘤患者63例的临床资料.结果:假性动脉瘤破裂52例,住院期间再次或多次出血者26例.行髂外动脉-股浅动脉旁路带环人工血管重建术49例,行髂外动脉或股动脉结扎术14例.围手术期无死亡.1例住院期间出现移植物感染,5例随诊期间出现移植物感染,感染的移植物取出后同时行髂外动脉或股动脉结扎保肢成功.1例行股动脉结扎患者术后出现肢体坏死行大腿截肢.其余手术患者均恢复良好.36例复诊彩超检查示人工血管通畅.结论:尽早外科手术是抢救因注射毒品致感染性假性动脉瘤患者生命的唯一途径;彻底清创引流、髂外动脉-股浅动脉旁路带环人工血管重建以及控制感染是治疗的有效方法;在感染严重且局部条件无法重建血管的情况下,结扎髂外动脉或股动脉也是一种救治患者的可行选择.%Objective To investigate the surgical management of infected pseudoaneurysms of femoral artery caused by narcotics injection.Methods The clinical data of 63 cases of infected pseudoaneurysms of femoral artery caused by narcotics injection were reviewed retrospectively.Results The tumors in 52 cases ruptured. Rupture hemorrhoea first occurred in 45 patients before admission and in 7 during hospitalization. Twenty-six patients suffered from recurrent or multiple hemorrhoea while in hospital. Forty-nine patients received external iliac artery-superficial femoral artery extra-anatomic bypass reconstruction with banded vascular grafts and the other 14 received ligation operations of the external iliac artery or the femoral artery. No one died in the perioperative period. One patient with vascular graft reconstruction developed graft infection during hospitalization and 5 developed graft infection during the follow-up. No ischemic necrosis occurred

  10. A Case of Persistent Sciatic Artery Aneurysm Accompanied by a Persistent Sciatic Vein

    OpenAIRE

    Tadakoshi, Masao; Ohta, Takashi; Ishibashi, Hiroyuki; Sugimoto, Ikuo; Iwata, Hirohide; Yamada, Tetsuya; Hida, Noriyuki; Orimoto, Yuki

    2010-01-01

    A persistent sciatic artery is a rare anomaly. On the other hand, a persistent sciatic vein is frequently associated with Klippel-Trenaunay syndrome. In a 71-year-old female with a complete-type persistent sciatic artery aneurysm, we performed aneurysmectomy and right femoropopliteal bypass surgery. The right popliteal vein drained into the femoral vein via a lower-type persistent sciatic vein and the deep femoral vein. The superficial femoral artery and vein were hypoplastic. Since only 4 ca...

  11. The Observation on Efficacy of Angio-seal Closure Device in the Femoral Arterial Puncture Site after PCI

    Institute of Scientific and Technical Information of China (English)

    Zhang Bin; Jin Lijun; Wei Shuishen; Fang Xianhong; Wu Handong; Dong Taiming; Yan hong; Liao Hongtao

    2006-01-01

    Objective To evaluatereliability and safety of Angio-seal hemostasis device applied to the femoral arterial puncture site after percutaneous coronary intervention (PCI). Methods In 40 patients after PCI in our institute during the period between May 2002 and December 2003, Angioseal device were used to seal the femoral arterial puncture site. Results All the Angioseal devices were successfully deployed in 40 patients (successful rate:100%); the mean time to hemostasis was 45±12 sec;the mean time to ambulate after angioseal closure was 1.9±0.5 hours. No major groin and systemic complication was observed. There was minor groin oozing in 2 cases and small hemotoma in 1 patient.Conclusions Angio-seal closure device of the femoral artery puncture site after a percutaneous coronary procedure is safe. It can shorten the time to hemostasis,leads to early mobilization, and reduce groin complication. The disadvantage is relatively expensive.

  12. Superficial temporal artery-middle cerebral artery bypass surgery in a pediatric giant intracranial aneurysm presenting as migraine-like episodes.

    Science.gov (United States)

    Goedee, H S; Depauw, P R A M; vd Zwam, B; Temmink, A H

    2009-02-01

    Aneurysms of the intracranial arteries in the pediatric population are reportedly rare. There is a male predominance, association with connective tissue disorders, as well as bacterial, mycotic infections, and trauma. Common sites of presentation are the internal carotid artery bifurcation, posterior circulation, and distal segment of middle cerebral artery. Clinical manifestations can vary from seizures and subarachnoidal hemorrhage to headache, irritability, lethargy, vomiting, or focal motor deficits. Current treatment modalities encompass endovascular or surgical approach. We present a case report on an 11-year-old girl with migraine-like episodes due to an underlying giant fusiform middle cerebral artery aneurysm treated successfully with two superficial temporal artery-middle cerebral artery bypasses.

  13. Successful Treatment of Two Cases of Squamous Cell Carcinoma on the Ear with Intra-Arterial Administration of Peplomycin through a Superficial Temporal Artery

    Directory of Open Access Journals (Sweden)

    Takahiro Haga

    2014-09-01

    Full Text Available Cutaneous squamous cell carcinoma (SCC is the second most common non-melanoma skin cancer and tends to develop in sun-exposed cosmetic areas, including the ear. In this report, we describe two cases of SCC on the ear successfully treated with intra-arterial administration of peplomycin through a superficial temporal artery. In addition to this selective chemotherapy, we administered oral tegafur, which achieved complete remission of the tumor. These findings suggest that intra-arterial administration of peplomycin with tegafur is one of the optimal therapies for the treatment of SCC developing on the ear.

  14. Iatrogenic Injury of Profunda Femoris Artery Branches after Intertrochanteric Hip Screw Fixation for Intertrochanteric Femoral Fracture: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Nikolaos Patelis

    2014-01-01

    Full Text Available A case of arterial rupture of the profunda femoris arterial branches, following dynamic hip screw (DHS fixation for an intertrochanteric femoral fracture, is presented. Bleeding is controlled by coil embolization, but, later on, the patient underwent orthopedic material removal due to an infection of a large femoral hematoma.

  15. A Case of Urethral Reconstruction Using a Superficial Circumflex Iliac Artery

    Directory of Open Access Journals (Sweden)

    Kun-Woon Yoo

    2012-05-01

    Full Text Available A radial forearm free flap has been conventionally used for urethral reconstruction. However, aesthetic and functional complications occur frequently at the donor site. The use of a superficial circumflex iliac artery perforator (SCIP flap can resolve these disadvantages. Here, we report our case with a review of literature. A 69-year-old man visited our hospital with multiple contusions of the abdomen and genital amputation. After necrotic tissue debridement, the length of the residual corpus carvernosum was 1.5 cm and that of the corpus spongiosum and urethra was 1 cm. For the reconstruction of the penis, a SCIP flap and anterolateral thigh free flap was performed. The primary closure was performed at the donor site. Three weeks postoperatively, the patient had a urethral foley catheter removed. The neourethra was functioning well without stricture. Four months postoperatively, the patient had no complications such as urethral stricture. A good recovery was also achieved with no aesthetic deficits at the donor site. SCIP flap is appropriate for urethral reconstruction. Because of its proximity to the recipient sites, it makes surgical preparation easier and the primary closure at the donor site available. It is also advantageous in that its location is almost unnoticeable.

  16. Application of ringing of superficial femoral vein for deep venous insufficiency%股浅静脉戴戒术在下肢深静脉瓣膜功能不全中的应用评价

    Institute of Scientific and Technical Information of China (English)

    周克堂; 吴成稳; 周志强

    2013-01-01

    目的 探讨股浅静脉戴戒术治疗下肢深静脉瓣膜功能不全的体会及评价.方法 回顾分析2008年1月至2011年9月睢县人民医院收治的80例行股浅静脉戴戒术患者病例资料.结果 80例患者均行股浅静脉戴戒术,通过术后随访和影像学复查,疗效显著.结论 股浅静脉戴戒术在下肢深静脉瓣膜功能不全的治疗中效果满意,适于各基层医院应用.%Objective To evaluate the experience of surgical treatment of deep venous insufficiency by ringing of superficial femoral vein. Methods A retrospectively analysis for the data of 80 patients was treated in our hospital with ringing of superficial femoral vein from Jan. 2008 to Sep. 2011. Results All the patients was treated by the ringing of superficial femoral vein,the symptoms were alleviated through postoperative follow -up and imaging review. Conclusions Use the ringing of superficial femoral vein is a more effective method for the deep venous insufficiency of patients. Suitable for the application of basic-level hospitals.

  17. Effect of cholesterol lowering on stiffness of aortic and femoral arterial walls in rabbits on a high fat diet

    Institute of Scientific and Technical Information of China (English)

    XUE Li; XU Wan-hai; XU Jin-zhi; ZHANG Tong; BI Hong-yuan; SHEN Bao-zhong

    2009-01-01

    Background Researches in arterial elasticity have increased over the past few years. We investigated the effects of simvastatin on vascular stiffness in fat fed rabbits by ultrasonography.Methods Thirty rabbits were assigned randomly to 3 groups: normal control group (A), the cholesterol group (B), simvastatin group (C: high fat diet for 4 weeks and high fat diet + simvastatin for further 4 weeks). Stiffness coefficient, pressure strain elastic modulus and velocity of pulse waves in abdominal aorta and femoral artery were measured by ultrasonographic echo tracking at the end of the 4th and the 8th weeks.Results At the end of the 4th week, stiffness coefficient, pressure strain elastic modulus and pulse wave velocity of femoral artery were significantly increased in group B compared with those in group A. Similarly, at the end of the 8th week, the same parameters of abdominal aorta were significantly increased in group B compared with those in group A. In contrast, stiffness coefficient, pressure strain elastic modulus and pulse wave velocity of femoral artery were significantly decreased in group C compared with those in group B, however, there was no significant difference in parameters of abdominal aorta between groups B and C.Conclusion Short term administration of simvastatin can improve the elasticity of femoral artery but not abdominal aorta.

  18. Rosiglitazone reverses endothelial dysfunction but not remodeling of femoral artery in Zucker diabetic fatty rats

    Directory of Open Access Journals (Sweden)

    Onyia Jude E

    2010-05-01

    Full Text Available Abstract Objectives Endothelial dysfunction precedes atherogenesis and clinical complications in type 2 diabetes. The vascular dysfunction in Zucker diabetic fatty (ZDF rats was evaluated at different ages along with the effect of treatment with rosiglitazone (Rosi on endothelial function and mechanical remodeling. Methods The Rosi treatment was given to ZDF rats for 3 weeks. The endothelium-dependent vasodilation and α-adrenoceptor-dependent vasoconstriction of femoral arteries were studied using an ex-vivo isovolumic myograph. The biomechanical passive property of the arteries was studied in Ca2+-free condition. The expressions of endothelial nitric oxide synthase (eNOS, α-adrenoceptor, matrix metalloproteinase 9 (MMP9, and elastase were evaluated. Results Endothelium-dependent vasorelaxation of the femoral artery was blunted at low doses in ZDF rats at 11 weeks of age and attenuated at all doses in ZDF rats at 19 weeks of age. The expression of eNOS was consistent with the endothelium-dependent vasorelaxation. The α-adrenoceptor was activated and the mechanical elastic modulus was increased in ZDF rats at 19 weeks of age. The expressions of α-adrenoceptor, MMP9, and elastase were up regulated in ZDF rats at 19 weeks of age. Rosi treatment for 3 weeks restored endothelium-dependent vasorelaxation and the expression of eNOS and the adrenoceptor activation at the doses below 10-6 mole/L in ZDF rats at 19 weeks of age. Rosi treatment for 3 weeks did not, however, improve the mechanical properties of blood vessel, the expressions of α-adrenoceptor, MMP9, and elastase in ZDF rats. Conclusion The endothelial dysfunction and mechanical remodeling are observed as early as 19 weeks of age in ZDF rat. Rosi treatment for 3 weeks improves endothelial function but not mechanical properties.

  19. Single stage reconstruction of ruptured tendoachilles tendon with skin cover using distally based superficial sural artery flap.

    Science.gov (United States)

    Abhyankar, Suhas V; Kulkarni, Ananta; Agarwal, Naveen Kumar

    2009-10-01

    Ruptured tendoachilles along with skin defect is a complex problem to reconstruct. Both things require a priority. Single stage reconstruction of ruptured tendoachilles tendon with skin cover using distally based superficial sural arterial flap allows us to perform both. This procedure gives excellent result, shortens the stay, thereby reducing the cost. This method is a simple solution to the complex problem like ruptured tendoachilles with skin defect. In this study, 6 patients with rupture of tendoachilles tendon due to penetrating injury, with skin defect are presented. The repair was done using aponeurotic part of tendoachilles tendon, taken from proximal part of tendoachilles in the midline measuring around 2 to 2.5 cm in width and 8 to 10 cm in length, with intact distal attachment. The tendon was turned upside down by 180 degrees and sutured to the distal stump of the tendoachilles tendon without tension. The skin defect was covered using distally based superficial sural artery flap in the same sitting. The follow-up period was 9 to 30 months. All patients showed good results. In one patient there was distal necrosis of 1.5 cm of the distally based superficial sural artery flap, which healed satisfactorily with conservative treatment. Single stage tendoachilles reconstruction can be used with good functional result and patient satisfaction.

  20. Effects of 8 hemodynamic conditions on direct blood pressure values obtained simultaneously from the carotid, femoral and dorsal pedal arteries in dogs.

    Science.gov (United States)

    Monteiro, Eduardo R; Campagnol, Daniela; Bajotto, Gustavo C; Simões, Clarissa R; Rassele, Alice C

    2013-12-01

    This study aimed to evaluate the effect of 8 hemodynamic conditions on blood pressure measurements taken from the carotid, femoral and dorsal pedal arteries of dogs. Six healthy dogs. During isoflurane anesthesia, catheters were introduced into the carotid, femoral and dorsal pedal arteries of dogs to allow simultaneous monitoring of direct blood pressure in each artery. The dogs were submitted to 8 hemodynamic conditions induced by combining changes in heart rate (bradycardia, normocardia, tachycardia) with changes in blood pressure (hypotension, normotension, hypertension). Values obtained from each arterial catheter were compared and agreement between central (carotid) and peripheral (femoral and dorsal pedal) values were analyzed by the Bland-Altman method. During hypotensive conditions, systolic arterial pressure (SAP) was lower in the femoral and dorsal pedal arteries compared to the carotid artery whereas during normotensive and hypertensive conditions, SAP was higher in peripheral arteries. During hypotensive states, increases in heart rate resulted in greater bias between central and peripheral SAP whereas during normotensive states, the bias decreased as heart rate increased. Mean and diastolic arterial pressures were lower in the femoral and dorsal pedal arteries than in the carotid artery during most hemodynamic conditions. In healthy anesthetized dogs, invasive blood pressure measurements in peripheral arteries may differ significantly from measurements in a central artery. The greatest differences were observed in SAP and the magnitude of differences between central and peripheral blood pressure measurements varied according to the dog's hemodynamic condition. Copyright © 2013 Elsevier B.V. All rights reserved.

  1. Ultrasound-guided Femoral Artery Access for Minimally Invasive Neuro-intervention and Risk Factors for Access Site Hematoma

    Science.gov (United States)

    KURISU, Kota; OSANAI, Toshiya; KAZUMATA, Ken; NAKAYAMA, Naoki; ABUMIYA, Takeo; SHICHINOHE, Hideo; SHIMODA, Yusuke; HOUKIN, Kiyohiro

    2016-01-01

    Although ultrasound (US) guidance for venous access is becoming the “standard of care” for preventing access site complications, its feasibility for arterial access has not been fully investigated, especially in the neuro-interventional population. We conducted the first prospective cohort study on US-guided femoral artery access during neuro-interventional procedure. This study included 64 consecutive patients who underwent US-guided femoral artery access through 66 arterial access sites for diagnostic and/or neuro-interventional purposes. The number of attempts required for both the sheath insertion and the success of anterior wall puncture were recorded. In addition, the occurrence of major complications and hematoma formation on the arterial access site examined by US were statistically analyzed. The median number of attempts was 1 (1–2) and first-pass success rate was 63.6%. Anterior wall puncture was achieved in 98.5%. In one case (1.5%), a pseudoaneurysm was observed. In all cases, US clearly depicted a common femoral artery (CFA) and its bifurcation. Post-procedural hematoma was detected in 13 cases (19.7%), most of which were “tiny” or “moderate” in size. Low body mass index and antiplatelet therapy were the independent risk factors for access site hematoma. The US-guided CFA access was feasible even in neuro-interventional procedure. The method was particularly helpful in the patients with un-palpable pulsation of femoral arteries. To prevent arterial access site hematoma, special care should be taken in patients with low body mass index and who are on antiplatelet therapy. PMID:27194178

  2. Effects of external gamma radiation on femoral artery reimplantation in rats: morphometrical analyzes

    Directory of Open Access Journals (Sweden)

    Costa Regina de Faria Bittencourt da

    2003-01-01

    Full Text Available PURPOSE: To investigate the effects of external gamma radiation on rat femoral artery reimplant. METHODS: Sixty-two male Wistar rats were distributed in two groups I (Control and II (Irradiated, both formed by three observation subgroups: 2 (10 animals, 7 (11 and 21(10 postoperative days (PO. The right femoral artery of each animal was split up and reimplanted (end-to-end anastomosis, through microsurgery technique. In the first PO day group II animals were irradiated with a single dose of 15Gy, external source. The histological analysis, qualitative and descriptive analysis, was accomplished through hematoxylin and eosin (HE, Verhoeff and Masson trichromium methodology. Morphometric analysis was realized in the same slides used to histological analysis stained by HE. Computer software was used to quantify morphological alterations of the vascular wall, by processing captured images from a microscope. It was analyzed the intimal layer (intimal hyperplasia and endothelium cells formation and the nuclei percentage of smooth muscular cell in the medium layer and in the intima hyperplasia. The data were treated applying the statistical tests: Fisher's exact, Chi-square, Mann-Whitney, Kruskal-Wallis and analysis of variance (p < .05. RESULTS: The patency graft was observed by microscope distal to the autograft in 93.5% (29/31. It was observed that the gamma-radiation reduced the degree of covering of the vascular wall for the neo-formed endothelium. The nuclei percentage of smooth muscular cells, in the media, was smaller compared to control animals, although it was no significant for the studied sample size. The irradiated group showed a significant lower luminal stenosis and the intimal hyperplasia occurrence. In this group the percentage of smooth muscular cells proliferation, in the media, were significantly lower for 7 and 21 days of observation. CONCLUSION: The external single dose of 15 Gy gamma-radiation delivered at first postoperative day

  3. Anatomical variants of the superficial temporal artery in patients with microtia: a pilot descriptive study

    Science.gov (United States)

    Yong, Chong Kong; Das, Srijit; Huei, Yap Lok

    2016-01-01

    Superficial temporal artery (STA) based pedicled fascial flap plays a pivotal role in ear reconstruction for microtia patients. There is paucity of literature on the anatomy of the STA in microtia patients. The present study aimed to describe any possible anatomical variations seen in the STA of patients afflicted with microtia. Pre-operative carotid computer tomographic angiography images of patients under the microtia database of Plastic and Reconstructive Surgery Unit at a tertiary medical centre were selected and 3-dimensionally reconstructed. Measurements were made on the 3D reconstructed computed tomographic angiography images of the STA on both the sides of the microtic ear and the non-microtic ear to assess its various anatomical parameters. We managed to obtain a total of 39 computed tomographic angiography images of STAs for analysis. There was a significant difference in the number of main branches of STA between the two groups (P=0.006). The proportion of ears with 2 main branches was higher in the non-microtia group (89.5%) compared to the microtia group (45.0%). A significant difference was found in the STA diameter between the two groups (P=0.012). The mean diameter of STA in the non-microtia group was larger by 0.4 mm. Furthermore, the median angle of STA was larger on the side of the non-microtic ears compared to that of microtic ears by 24.5°, with a P-value of 0.011. The results of the study may be of clinical importance while planning and performing ear reconstructive surgeries using STA based pedicled fascial flaps. PMID:28127502

  4. Differences in perioperative femoral and radial arterial blood pressure in neonates and infants undergoing pediatric cardiac surgery requiring cardiopulmonary bypass.

    Science.gov (United States)

    Cho, Hwa Jin; Lee, Sang Hoon; Jeong, In Seok; Yoon, Nam Sik; Ma, Jae Sook; Ahn, Byoung Hee

    2017-08-30

    Several reports claim that blood pressure (BP) in the radial artery may underestimate the accurate BP in critically ill patients. Here, the authors evaluated differences in mean blood pressure (MBP) between the radial and femoral artery during pediatric cardiac surgery to determine the effectiveness of femoral arterial BP monitoring. The medical records of children under 1 year of age who underwent open-heart surgery between 2007 and 2013 were retrospectively reviewed. Radial and femoral BP were measured simultaneously, and the differences between these values were analyzed at various times: after catheter insertion, after the initiation of cardiopulmonary bypass (CPB-on), after aortic cross clamping (ACC), after the release of ACC, after weaning from CPB, at arrival in the intensive care unit (ICU), and every 6h during the first day in the ICU. A total of 121 patients who underwent open-heart surgery met the inclusion criteria. During the intraoperative period, from the beginning to the end of CPB, radial MBPs were significantly lower than femoral MBPs at each time-point measured (p60min, odds ratio: 7.47) was a risk factor for lower radial pressure. However, discrepancies between these two values disappeared after arrival in the ICU. There was no incidence of ischemic complications associated with the catheterization of both arteries. The authors suggest that femoral arterial pressure monitoring can be safely performed, even in neonates, and provides more accurate BP values during CPB-on periods, and immediately after weaning from CPB, especially when CPB time was greater than 60min. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  5. Covered stents for endovascular repair of iatrogenic injuries of iliac and femoral arteries

    Energy Technology Data Exchange (ETDEWEB)

    Kufner, Sebastian, E-mail: kufners@dhm.mhn.de [Deutsches Herzzentrum München, Technische Universität München, Munich (Germany); Cassese, Salvatore; Groha, Philipp; Byrne, Robert A. [Deutsches Herzzentrum München, Technische Universität München, Munich (Germany); Schunkert, Heribert; Kastrati, Adnan [Deutsches Herzzentrum München, Technische Universität München, Munich (Germany); DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich (Germany); Ott, Ilka; Fusaro, Massimiliano [Deutsches Herzzentrum München, Technische Universität München, Munich (Germany)

    2015-04-15

    Background: The growing number of complex endovascular procedures is expected to increase the risk of iatrogenic injuries of peripheral arteries. A strategy of percutaneous transluminal angioplasty (PTA) with covered stent (CS) may represent a valuable alternative to open surgery. However, systematic evaluations of CS in this setting represent a scientific gap. In the present study, we investigate the procedural and clinical outcomes associated with PTA and CS implantation to repair iatrogenic injuries of peripheral arteries. Methods: All patients undergoing PTA with CS for endovascular repair of iatrogenic injuries of peripheral arteries between August 2010 and July 2013 at our Institution were retrospectively analyzed. The primary endpoint was the technical success. Secondary endpoints were in-hospital mortality and cumulative death, target lesion revascularization (TLR), amputation and major stroke at 12-month follow-up. Results: During the period of observation, a total of 30 patients underwent PTA with either self-expandable (43.3%) or balloon-expandable CS (56.7%) for iatrogenic injuries of peripheral arteries. Injuries consisted of perforation/rupture (76.7%), arteriovenous fistula (16.7%) and pseudoaneurysm (6.7%) of iliac–femoral arteries. Technical success was achieved in all cases. Median follow-up was 409 days [210–907]. The incidence of in-hospital mortality was 10.0%. At 12-month follow-up, the incidence of death, TLR, amputation and major stroke was 20.0%, 17.0%, 3.3% and 6.7%, respectively. Conclusion: The use of covered stents for endovascular repair of iatrogenic injuries of peripheral arteries shows a high technical success and may be alternative to surgery. Further studies with larger populations are needed to confirm these preliminary findings. - Highlights: • The growing number of complex endovascular procedures is expected to increase the risk of iatrogenic injuries of peripheral arteries. • Percutaneous transluminal angioplasty with

  6. Five years' experience of transverse groin incision for femoral artery access in arterial reconstructive surgery: parallel observational longitudinal group comparison study.

    LENUS (Irish Health Repository)

    Beirne, Christopher

    2008-07-01

    Vertical groin incisions (VGIs) have been used to access femoral vessels, but reports allude to wound complications. Our aim was to compare VGI with transverse groin incision (TGI) for femoral artery exposure. Over a 5-year interval, 196 patients with 284 femoral artery exposures for supra- and infrainguinal procedures were studied. Primary endpoints were surgical skin site wound infection, seroma, haematoma formation, and major lower limb amputation. Secondary endpoints were graft patency, wound paresthesias, and length of hospital stay. There were 160 TGIs and 124 VGIs. The demographics and risk factor profile were not statistically different between groups. Seroma developed in 4.4% of TGIs and 13.7% of VGIs (p= .005). The complicated skin and soft tissue infection rate was five times greater with VGI (p= .001). The VGI group had a significantly higher rate of major amputation (p= .0005). Significantly higher graft failure rates were observed in the VGI group (p= .011). No paresthesia was reported in any TGI wound. The mean hospital stay was also significantly shorter in the TGI group (p= .006). The study data support and expound on the theory that an alternative incision to VGI offers lower short- and long-term morbidity. Our findings sustain the selection of the TGI in femoral artery surgery for both supra- and infrainguinal procedures without compromise of vessel exposure.

  7. Koroner Arter Kalsiyum Skor İndeksi ile Karotis ve Yüzeyel Femoral Arterlerin İntima Media Kalınlıkları Arasındaki İlişkinin Değerlendirilmesi

    OpenAIRE

    VARDI, Eşref Cem; BOZGEYİK, Zülkif; POYRAZ, Ahmed Kürşad; Onur, Mehmet Ruhi

    2012-01-01

    Objective: To investigate the relationship between intima-media thicknesses (IMT) of carotid and superficial femoral arteries and coronary artery calcium index quantified using Agatston score. Materials and Methods: Cardiac multidetector computed tomography (MDCT) angiography of 75 patients were included in the study. Coronary artery calcium scores were measured using a workstation. Calcium scores were calculated according to the Agatston method. Bilateral carotid artery and superficial f...

  8. Colgajos de perforantes de las arterias epigástricas inferiores profunda y superficial Deep and superficial inferior epigastric artery perforator flaps

    Directory of Open Access Journals (Sweden)

    A. R. Gagnon

    2006-12-01

    Full Text Available Con el desarrollo de los colgajos miocutáneos de recto abdominal (TRAM, el abdomen inferior ha sido reconocido como la principal área dadora de tejidos autólogos de alta calidad, especialmente útiles en reconstrucción mamaria. Más recientemente la habilidad para obtener componentes adiposocutáneos similares sin sacrificar el músculo recto ha revolucionado el campo de la Cirugía Reconstructiva. El advenimiento de los colgajos de perforantes ha permitido a los cirujanos plásticos lograr los mismos buenos resultados estéticos que con los colgajos miocutáneos tradicionales, pero con un considerable descenso en la morbilidad del área donante. Con los colgajos de perforantes de la arteria epigástrica inferior profunda (DIEP y de la arteria epigástrica inferior superficial (SIEA, los pacientes han incrementado sus opciones de reconstrucción. Este artículo revisa la anatomía quirúrgica de la pared abdominal relativa a los colgajos SIEA y DIEP. Se explican detalladamente los pasos principales para la preparación preoperatoria, la técnica quirúrgica y los cuidados postoperatorios. Se discuten las ventajas y desventajas y se presen- tan los trucos técnicos que pueden ayudar a mejorar el resultado final. Además se ilustran con ayuda de casos clínicos las indicaciones típicas y atípicas.Following the development of the transverse rectus abdominis myocutaneous (TRAM flap, the lower abdomen has been recognized as a prime source of high quality autogenous tissue, especially useful in breast reconstruction. More recently, the ability to harvest a similar adipocutaneous component without sacrifice of the rectus muscle has revolutionized the field of reconstructive surgery. The advent of perforator flaps has allowed plastic surgeons to achieve the same highly esthetic results as with the former myocutaneous flaps while significantly decreasing the donor site morbidity. With the deep inferior epigastric artery perforator (DIEP flap and

  9. Management of Isolated Atherosclerotic Stenosis of the Common Femoral Artery: A Review of the Literature.

    Science.gov (United States)

    Halpin, David; Erben, Young; Jayasuriya, Sasanka; Cua, Bennett; Jhamnani, Sunny; Mena-Hurtado, Carlos

    2017-05-01

    Common femoral endarterectomy (CFE) remains the standard of care for treatment of atherosclerotic stenosis of the common femoral artery (CFA). Endovascular interventions have become the first-line therapy for atherosclerotic disease of the aortoiliac and femoropopliteal systems. Recent reports have documented high rates of technical success and low rates of complications with endovascular management of CFA stenosis. This study is a contemporary review of the surgical and endovascular literature on the management CFA stenosis and compares the results of these methods. A search of OVID Medline identified all published reports of revascularization of isolated atherosclerotic CFA stenosis. For each study selected for review, the number of patients, number of limbs treated, percentage of patients with critical limb ischemia, and mean length of follow-up was recorded. Study end points included survival, primary patency, freedom from target lesion revascularization (TLR), freedom from amputation, and complications. The review included 7 CFE studies and 4 endovascular studies. Survival was similar between the groups. Primary patency was consistently higher with CFE compared to endovascular therapy. Freedom from TLR was lower with CFE compared to endovascular therapy. Morbidity and mortality was also higher with CFE compared to endovascular therapy. Freedom from amputation was not consistently reported in the endovascular studies. There is limited data to support endovascular treatment of isolated CFA atherosclerosis. CFE has durable results, but there is significant morbidity and mortality resulting from this procedure. Endovascular interventions have low rates of complications, high rates of technical success, good short-term patency but increased need for repeat interventions when compared to surgery. Further trial data comparing CFE with endovascular therapy is needed to guide the management of CFA stenosis.

  10. Children and Adolescent Obesity Associates with Pressure-Dependent and Age-Related Increase in Carotid and Femoral Arteries' Stiffness and Not in Brachial Artery, Indicative of Nonintrinsic Arterial Wall Alteration

    Science.gov (United States)

    García-Espinosa, Victoria; Curcio, Santiago; Castro, Juan Manuel; Arana, Maite; Giachetto, Gustavo; Chiesa, Pedro; Zócalo, Yanina

    2016-01-01

    Aim. To analyze if childhood obesity associates with changes in elastic, transitional, and/or muscular arteries' stiffness. Methods. 221 subjects (4–15 years, 92 females) were assigned to normal weight (NW, n = 137) or obesity (OB, n = 84) groups, considering their body mass index z-score. Age groups were defined: 4–8; 8–12; 12–15 years old. Carotid, femoral, and brachial artery local stiffness was determined through systodiastolic pressure-diameter and stress-strain relationships. To this end, arterial diameter and peripheral and aortic blood pressure (BP) levels and waveforms were recorded. Carotid-femoral, femoropedal, and carotid-radial pulse wave velocities were determined to evaluate aortic, lower-limb, and upper-limb regional arterial stiffness, respectively. Correlation analysis between stiffness parameters and BP was done. Results. Compared to NW, OB subjects showed higher peripheral and central BP and carotid and femoral stiffness, reaching statistical significance in subjects aged 12 and older. Arterial stiffness differences disappeared when levels were normalized for BP. There were no differences in intrinsic arterial wall stiffness (elastic modulus), BP stiffness relationships, and regional stiffness parameters. Conclusion. OB associates with BP-dependent and age-related increase in carotid and femoral (but not brachial) stiffness. Stiffness changes would not be explained by intrinsic arterial wall alterations but could be associated with the higher BP levels observed in obese children. PMID:27066273

  11. Three-dimensional computed tomography angiography for the investigation of superficial temporal artery pseudoaneurysms--two case reports--.

    Science.gov (United States)

    Higashino, Takuya; Kawashima, Masatou; Mannoji, Hiromichi

    2005-03-01

    An 89-year-old man and a 60-year-old man presented with superficial temporal artery (STA) pseudoaneurysms which developed secondary to trauma. Conventional cerebral angiography and three-dimensional computed tomography (3D CT) angiography clearly demonstrated the STA pseudoaneurysms. The patients underwent surgical excision of the aneurysms based on the conventional cerebral angiography findings in one patient and 3D CT angiography findings in other patient. 3D CT angiography is an excellent noninvasive diagnostic method for detecting extracranial aneurysms such as STA pseudoaneurysm, especially the relationship between the aneurysm and surrounding structures, including the calvarium.

  12. Distally based superficial sural artery flap for soft tissue coverage in the distal 2/3 of leg and foot

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    Kamath B

    2005-01-01

    Full Text Available Background: Skin coverage for defects in the lower 2/3 of leg, ankle region and posterior heel has always been a difficult challenge for reconstructive surgeon. Methods: We describe our experience with the distally based superficial sural artery flap coverage in 48 patients with moderate sized defects in these difficult areas. Results: One out of 48 flaps (in 48 patients was lost totally and 3 suffered marginal necrosis which did not require any secondary procedure. These complications could have been avoided by proper selection of cases and refining technical skills. Conclusion: This simple procedure could be an important and versatile tool for any reconstructive surgeon in providing skin coverage in the distal leg and proximal foot. Preservation of major arteries of the lower limb, minimal donor defect, relatively uninjured donor area in compound fracture or poly trauma involving distal leg are some of the advantages of the flap.

  13. Adipose inflammation initiates recruitment of leukocytes to mouse femoral artery: role of adipo-vascular axis in chronic inflammation.

    Directory of Open Access Journals (Sweden)

    Sumihiko Hagita

    Full Text Available BACKGROUND: Although inflammation within adipose tissues is known to play a role in metabolic syndrome, the causative connection between inflamed adipose tissue and atherosclerosis is not fully understood. In the present study, we examined the direct effects of adipose tissue on macro-vascular inflammation using intravital microscopic analysis of the femoral artery after adipose tissue transplantation. METHODS AND RESULTS: We obtained subcutaneous (SQ and visceral (VIS adipose tissues from C57BL/6 mice fed normal chow (NC or a high fat diet (HF, then transplanted the tissues into the perivascular area of the femoral artery of recipient C57/BL6 mice. Quantitative intravital microscopic analysis revealed an increase in adherent leukocytes after adipose tissue transplantation, with VIS found to induce significantly more leukocyte accumulation as compared to SQ. Moreover, adipose tissues from HF fed mice showed significantly more adhesion to the femoral artery. Simultaneous flow cytometry demonstrated upregulation of CD11b on peripheral granulocyte and monocytes after adipose tissue transplantation. We also observed dominant expressions of the inflammatory cytokine IL-6, and chemokines MCP-1 and MIP-1β in the stromal vascular fraction (SVF of these adipose tissues as well as sera of recipient mice after transplantation. Finally, massive accumulations of pro-inflammatory and dendritic cells were detected in mice with VIS transplantation as compared to SQ, as well as in HF mice as compared to those fed NC. CONCLUSION: Our in vivo findings indicate that adipose tissue stimulates leukocyte accumulation in the femoral artery. The underlying mechanisms involve upregulation of CD11b in leukocytes, induction of cytokines and chemokines, and accumulation of pro-inflammatory cells in the SVF.

  14. Diminished neurogenic femoral artery vasoconstrictor response in a Zucker obese rat model: differential regulation of NOS and COX derivatives.

    Directory of Open Access Journals (Sweden)

    Ana Cristina Martínez

    Full Text Available OBJECTIVE: Peripheral arterial disease is one of the macrovascular complications of type 2 diabetes mellitus. This study addresses femoral artery regulation in a prediabetic model of obese Zucker rats (OZR by examining cross-talk between endothelial and neural factors. METHODS AND RESULTS: Arterial preparations from lean (LZR and OZR were subjected to electrical field stimulation (EFS on basal tone. Nitric oxide synthase (NOS and cyclooxygenase (COX isoform expression patterns were determined by immunohistochemical labelling and Western blotting. Results indicate significantly reduced noradrenergic contractions in preparations from OZR compared with those of LZR. Functional inhibition of endothelial NOS (eNOS indicated a predominant role of this isoform in LZR and its modified activity in OZR. Neural (nNOS and inducible NOS (iNOS were activated and their expression was higher in femoral arteries from OZR. Neurotransmission modulated by large-conductance Ca2+-activated (BKCa or voltage-dependent (KV K+ channels did not seem compromised in the obese animals. Endothelial COX-1 and COX-2 were expressed in LZR and an additional adventitial location of COX-2 was also observed in OZR, explaining the higher COX-2 protein levels detected in this group. Prostanoids derived from both isoforms helped maintain vasoconstriction in LZR while in OZR only COX-2 was active. Superoxide anion inhibition reduced contractions in endothelium-intact arteries from OZR. CONCLUSIONS: Endothelial dysfunction led to reduced neurogenic vasoconstriction in femoral arteries from OZR. In a setting of obesity, NO-dependent nNOS and iNOS dilation activity could be an alternative mechanism to offset COX-2- and reactive oxygen species-mediated vasoconstriction, along with impaired endothelial NO relaxation.

  15. Efficacy and safety of percutaneous treatment of iatrogenic femoral artery pseudoaneurysm by biodegradable collagen injection.

    Science.gov (United States)

    Hamraoui, Karim; Ernst, Sjef M P G; van Dessel, Pascal F H M; Kelder, Johannes C; ten Berg, Jurriën M; Suttorp, Maarten Jan; Jaarsma, Wybren; Plokker, Thijs H W

    2002-04-17

    OBJECTIVES; The goal of this study was to assess the safety and efficacy of femoral artery pseudoaneurysm (FAP) closure by collagen injection. BACKGROUND; The FAP is an infrequent but troublesome complication after percutaneous transfemoral catheter procedures. If ultrasound-guided compression repair (UGCR) fails, vascular surgery is indicated. We have developed a less invasive method to close FAPs percutaneously by injecting collagen and, thus, inducing clotting within the aneurysm. Via a 9F needle or 11F sheath, a biodegradable adhesive bovine collagen is injected percutaneously into the FAP, guided by angiography from the contralateral site. From 1993 to 2000, compression and UGCR had failed to obliterate 110 FAPs. These patients have been treated by collagen injection. Mean age of the patients was 65.6 +/- 10.2 years (range: 32 to 85 years), and 50% were women. Immediate closure of the FAP was achieved in 107/110 patients (97.3%) without any complication or adverse effect. In one patient the collagen could not be applied due to unfavorable anatomy. One patient needed a second session of collagen injection. In one patient too much collagen was inserted, which resulted in external compression of the artery, and surgical intervention was required. The overall success rate was 108/110 (98%, 95% confidence interval: 93.5% to 99.8%). Among the patients with successful procedures, there were no recurrences during six months follow-up. The percutaneous treatment of iatrogenic FAP, by injection with collagen, is an effective and safe strategy. This method provides an excellent therapeutic alternative to the traditional surgical management.

  16. Femoral artery neointimal hyperplasia is reduced after wire injury in Ref-1+/- mice.

    Science.gov (United States)

    Basi, David L; Adhikari, Neeta; Mariash, Ami; Li, Qinglu; Kao, Esther; Mullegama, Sureni V; Hall, Jennifer L

    2007-01-01

    Redox factor-1 (Ref-1) is a multifunctional protein that regulates redox, DNA repair, and the response to cell stress. We previously demonstrated that Ref-1(+/-) mice exhibit a significantly reduced Ref-1 mRNA and protein levels within the vasculature, which are associated with increased oxidative stress. The goal of this study was to test the hypothesis that partial loss of Ref-1 altered the cellular response to vascular injury. Fourteen days after femoral artery wire injury, we found that vessel intima-to-media ratio was significantly reduced in Ref-1(+/-) mice compared with that in wild-type mice (P Ref-1(+/-) mice. In vitro studies found no significant changes in either serum-induced proliferation or baseline apoptosis in Ref-1(+/-) vascular smooth muscle cells. Exposure to Fas ligand; however, did result in increased susceptibility of Ref-1(+/-) vascular smooth muscle cells to apoptosis (P Ref-1(+/-) mice exhibited an increase in circulating baseline levels of IL-10, IL-1alpha, and VEGF compared with those in wild-type mice but a marked impairment in these pathways in response to injury. In sum, loss of a single allele of Ref-1 is sufficient to reduce intimal lesion formation and to alter circulating cytokine and growth factor expression.

  17. Short- and midterm results of the fascia suture technique for closure of femoral artery access sites after endovascular aneurysm repair.

    Science.gov (United States)

    Montán, Carl; Lehti, Leena; Holst, Jan; Björses, Katarina; Resch, Timothy A

    2011-12-01

    To evaluate the midterm outcomes and potential risk factors associated with the fascia suture technique (FST) for closure of femoral artery access sites after percutaneous endovascular aneurysm repair (EVAR). Between April 2007 and April 2008, 100 consecutive EVAR cases were evaluated retrospectively. A third of the procedures were emergent (16 ruptured aneurysms). Of the 187 femoral access sites, 160 (85.5%) were closed by the FST as a first choice. Pre- and postoperative chart and imaging data were collected from computerized medical records for analysis of demographics and the rate of complications (bleeding, infection, thrombosis, pseudoaneurysms, and stenosis). Preoperative risk factors for FST failure were analyzed with regard to obesity (based on the subcutaneous fat layer), plaque at the femoral access site, and stenosis based on the pre- and 1-year postoperative computed tomography scans. Of the 160 FST closures, 146 (91.3%) were technically successful. The 14 (8.8%) technical failures were converted to open cutdown intraoperatively because of bleeding (11, 6.8%), inadequate limb perfusion (2, 1.2%), and a broken guidewire (1, 0.6%). Two (1.2%) pseudoaneurysms required surgical repair after 2 weeks. Data from the 1-year follow-up showed no signs of increased stenosis, thrombosis, or formation of plaque. Nine small (<1 cm(3)) pseudoaneurysms were detected and managed conservatively. No preoperative risk factors were associated with FST failure. The fascia suture technique seems to be safe, effective, and simple to use for closing percutaneous access sites after EVAR. Complications are rare, and the outcome is not affected by obesity, femoral calcification, or femoral artery stenosis.

  18. TRPA1 Mediates Amplified Sympathetic Responsiveness to Activation of Metabolically Sensitive Muscle Afferents in Rats with Femoral Artery Occlusion

    Directory of Open Access Journals (Sweden)

    Jihong eXing

    2015-09-01

    Full Text Available Autonomic responses to stimulation of mechanically and metabolically sensitive muscle afferent nerves during static contraction are augmented in rats with femoral artery occlusion. Moreover, metabolically sensitive transient receptor potential cation channel subfamily A, member 1 (TRPA1 has been reported to contribute to sympathetic nerve activity (SNA and arterial blood pressure (BP responses evoked by static muscle contraction. Thus, in the present study, we examined the mechanisms by which afferent nerves’ TRPA1plays a role in regulating amplified sympathetic responsiveness due to a restriction of blood flow directed to the hindlimb muscles. Our data show that 24-72 hrs of femoral artery occlusion 1 upregulates the protein levels of TRPA1 in dorsal root ganglion (DRG tissues; 2 selectively increases expression of TRPA1 in DRG neurons supplying metabolically sensitive afferent nerves of C-fiber (group IV; and 3 enhances renal SNA and BP responses to AITC (a TRPA1 agonist injected into the arterial blood supply of the hindlimb muscles. In addition, our data demonstrate that blocking TRPA1 attenuates SNA and BP responses during muscle contraction to a greater degree in ligated rats than those responses in control rats. In contrast, blocking TRPA1 fails to attenuate SNA and BP responses during passive tendon stretch in both groups. Overall, results of this study indicate that alternations in muscle afferent nerves’TRPA1 likely contribute to enhanced sympathetically mediated autonomic responses via the metabolic component of the muscle reflex under circumstances of chronic muscle ischemia.

  19. Ambulatory instrument for monitoring indirect beat-to-beat blood pressure in superficial temporal artery using volume-compensation method.

    Science.gov (United States)

    Tanaka, S; Yamakoshi, K

    1996-11-01

    A portable instrument, based on a volume-compensation technique, is designed for ambulatory monitoring of indirect beat-to-beat blood pressure (BP) in the superficial temporal artery. The instrument consists of a small disc-type cuff and a portable unit carried by the subject. Several components are integrated in the cuff for applying counter-pressure to the artery, i.e. a reflectance-type photo-plethysmographic sensor for arterial volume detection, a pressure sensor for cuff pressure Pc measurement and a nozzle flapper-type- electro-pneumatic convertor for controlling Pc. The portable unit includes volume servo control circuitry and a microprocessor-based signal-processing and recording unit. This automatically performs all the necessary measurement procedures and stores into a memory IC element the processed systolic, mean and diastolic blood pressure data, together with pulse intervals on a beat-to-beat basis from the servo-controlled Pc (indirectly measured BP waveform). With this instrument, momentary changes in BP during ambulatory situations such as bicycle ergometer exercise and daily activities including motorway driving are successfully recorded. From the results of simultaneous measurement of the subject's posture changes, the effect of posture change on blood pressure, e.g. baroreceptor-cardiac reflex, is also clearly demonstrated.

  20. The clinical application of reconstitution of deep femoral arterial blood flow in improving the ischemic symptoms of lower extremities%股深动脉血流重建改善下肢缺血的临床应用

    Institute of Scientific and Technical Information of China (English)

    陈国平; 顾建平; 楼文胜; 何旭; 陈亮; 苏浩波; 宋进华; 汪涛; 徐克

    2011-01-01

    Objective To investigate the clinical application of reconstitution of deep femoral arterial blood flow in improving the ischemic symptoms of lower extremities. Methods A total of 11 patients with arteriosclerosis obliteration received intravascular blood flow reconstitution by using deep femoral arteries as outflow tract or inflow tract when the superficial femoral arteries could not be reopened. The therapeutic effect was retrospectively analyzed. Six cases received percutaneous transluminal angioplasty ( PTA ) and/or stent implantation in iliac and common femoral arteries. while 4 cases only received PTA in deep f'emoral arteries.One case had PTA and/or stent placement in iliac and common femoral artery and only PTA in deep femoral artery at the same time. Results After operation, the pain gradually disappeared in 5 patients and skin temperature increased significantly. Of the five cases. toe ulcer exudation got dry in two after 3 days or after 10 days respectively, and the ulcers healed completely in 3 months when the follow-up was regularly conducted. In three cases the pain disturbed normal sleep before the treatment. which could not be relieved by common analgesics. After operation the pain occasionally appeared and could be tolerated even with no use of common analgesics. In one case the gangrenous toe fell off two months after the operation without surgical intervention. Because of severe lower extremity ischemia. two cases had to receive surgical limb amputations above knee. and the wound healed in one month. Two cases lost touch with the authors at 6-month follow-up, and intermittent claudication developed in five cases during follow-up period. After the treatment. the ankle-brachial index ( ABI ) became ( 0.71 ± 0.21 ). while it was ( 0.32 ± 0.19 ) before the treatment, the difference between the two was statistically signif'icant ( P <0.05). Conclusion When the iliofemoral artery or superficial femoral artery is extensively occluded , deep femoral

  1. Ultrasound-guided femoral arterial access in pediatric cardiac catheterizations: A prospective evaluation of the prevalence, risk factors, and mechanism for acute loss of arterial pulse.

    Science.gov (United States)

    Alexander, John; Yohannan, Thomas; Abutineh, Iman; Agrawal, Vijaykumar; Lloyd, Hannah; Zurakowski, David; Waller, B Rush; Sathanandam, Shyam

    2016-12-01

    The objectives of this study were to describe the prevalence, mechanisms, and identify risk factors for acute loss of arterial pulse (LOP) in children who had ultrasound-guided femoral arterial access (UGFAA) during cardiac catheterization. LOP is a known complication in children following femoral arterial (FA) access for cardiac catheterization. The prevalence of LOP requiring treatment ranges between 4% and 8%. A prospective study was performed including 486 cardiac catheterizations using UGFAA in children ≤18 years over a 3 years period. Ultrasound and Doppler evaluations were performed prior to and at the end of the procedure. LOP was identified in 33 cases (6.8%) with 23 (4.7%) requiring treatment. For children ≤6 months, the prevalence of LOP requiring treatment was 13.6%. FA diameter LOP (OR: 8.44, 95% CI: 2.07-34.5, P LOP had a greater percentage decrease in vessel diameter (median 62% vs 18%, P LOP. FA thrombus was diagnosed only in 9 patients (27% of those with LOP). The prevalence of LOP requiring treatment is 4.7% when UGFAA is used during pediatric cardiac catheterizations. Arterial spasm was more common than thrombus as a cause of LOP. FA diameter LOP in this carefully designed prospective study. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  2. Immediate reconstruction using free medial circumflex femoral artery perforator flaps after breast-conserving surgery.

    Science.gov (United States)

    Izumi, Ken; Fujikawa, Masakazu; Tashima, Hiroki; Saito, Takuya; Sotsuka, Yohei; Tomita, Koichi; Hosokawa, Ko

    2013-11-01

    Recent advances in perforator flap surgical techniques have allowed for safe and reliable autologous tissue transfer with minimal donor-site morbidity. Between April 2012 and January 2013, we performed immediate breast reconstruction using free medial circumflex femoral artery perforator (MCFAP) flaps in 15 patients after breast-conserving surgery. The flaps were harvested from patients in the lithotomy position, while a second surgical team simultaneously conducted tumour resection. Of the 15 procedures performed, three flaps were dissected as true perforator flaps, while 12 flaps were dissected as muscle-sparing perforator flaps. The mean flap weight was 138.5 g (range, 77-230 g) and the mean pedicle length was 5.7 cm (range, 3.0-9.0 cm). Recipient vessels for anastomosis were serratus branches in 10 patients, internal mammary vessels in three patients and thoracodorsal vessels in two patients. The mean duration of surgery was 6.74 h (range, 5.65-9.45 h). There were no major complications requiring surgical intervention. Researchers observed partial flap necrosis, which manifested as small firm lesions in two patients, as well as local wound infection and dehiscence in one patient, which resolved spontaneously. There were no instances of donor-site seroma formation or lymphoedema in any of the patients. An objective assessment of postoperative photographs showed that cosmetic results were mostly satisfactory. Donor-site scars along the medial groin crease were inconspicuous and readily concealed by clothing. Given its reliable vascularity and minimal donor-site morbidity, the free MCFAP flap can be a good alternative for partial breast reconstruction after breast-conserving surgery.

  3. Use of lateral circumflex femoral artery system free flaps in skull base reconstruction.

    Science.gov (United States)

    Camporro, Daniel; Fueyo, Angel; Martín, Clara; Carnero, Susana; Llorente, José L

    2011-05-01

    We present a 10-year retrospective study at a tertiary center designed to evaluate the advantages, complications, and comparative results using lateral circumflex femoral artery (LCFA) system free flaps for cranial base reconstruction. In this study, a cranial base defect refers to exposed intracranial contents to the skin, paranasal sinuses, nasopharynx, oropharynx, or oral cavity. These defects resulted from resections of primary or recurrent neoplasms or from secondary problems after cranial base surgery. We performed 20 flaps in 20 patients. The selection of flap was as follows: 8 combinations of anterolateral/anteromedial thigh flaps with vastus lateralis muscle or tensor fascia lata flaps, 6 ALT fasciocutaneous flaps, and 6 muscle/myocutaneous flaps. The flap's success rate was 95% (19/20). Early major complications included 1 perioperative death, and there was 1 myocardial infarction. Minor complications included 1 partial (12%) flap loss, 2 temporal cerebrospinal fluid leak, 2 donor-site hematoma, 2 minor wound breakdown, 3 facial nerve weakness, and 4 donor-site numbness. Among 20 patients undergoing LCFA system flap reconstruction, 12 are alive and disease free. Local recurrence occurred in 1 patient. She underwent ablative surgery and a new successful free flap (forearm flap); after 2 years, the patient is disease free. The LCFA system flaps in skull base reconstruction provide versatility in flap design and availability of adequate tissues to fill dead space, and it offers vascularized fascia to augment dural repairs. It also provides a very long pedicle and allows simultaneous flap harvest with low donor-site morbidity.

  4. Identification by ultrasound evaluation of the carotid and femoral arteries of high-risk subjects missed by three validated cardiovascular disease risk algorithms.

    Science.gov (United States)

    Postley, John E; Luo, Yanting; Wong, Nathan D; Gardin, Julius M

    2015-11-15

    Atherosclerotic cardiovascular disease (ASCVD) events are the leading cause of death in the United States and globally. Traditional global risk algorithms may miss 50% of patients who experience ASCVD events. Noninvasive ultrasound evaluation of the carotid and femoral arteries can identify subjects at high risk for ASCVD events. We examined the ability of different global risk algorithms to identify subjects with femoral and/or carotid plaques found by ultrasound. The study population consisted of 1,464 asymptomatic adults (39.8% women) aged 23 to 87 years without previous evidence of ASCVD who had ultrasound evaluation of the carotid and femoral arteries. Three ASCVD risk algorithms (10-year Framingham Risk Score [FRS], 30-year FRS, and lifetime risk) were compared for the 939 subjects who met the algorithm age criteria. The frequency of femoral plaque as the only plaque was 18.3% in the total group and 14.8% in the risk algorithm groups (n = 939) without a significant difference between genders in frequency of femoral plaque as the only plaque. Those identified as high risk by the lifetime risk algorithm included the most men and women who had plaques either femoral or carotid (59% and 55%) but had lower specificity because the proportion of subjects who actually had plaques in the high-risk group was lower (50% and 35%) than in those at high risk defined by the FRS algorithms. In conclusion, ultrasound evaluation of the carotid and femoral arteries can identify subjects at risk of ASCVD events missed by traditional risk-predicting algorithms. The large proportion of subjects with femoral plaque only supports the use of including both femoral and carotid arteries in ultrasound evaluation.

  5. Caveolar disruption causes contraction of rat femoral arteries via reduced basal NO release and subsequent closure of BKCa channels

    Directory of Open Access Journals (Sweden)

    AY Al-Brakati

    2015-05-01

    Full Text Available Background and Purpose. Caveolae act as signalling hubs in endothelial and smooth muscle cells. Caveolar disruption by the membrane cholesterol depleting agent methyl-β-cyclodextrin (M-β-CD has various functional effects on arteries including (i impairment of endothelium-dependent relaxation, and (ii alteration of smooth muscle cell (SMC contraction independently of the endothelium. The aim of this study was to explore the effects of M-β-CD on rat femoral arteries.Methods. Isometric force was measured in rat femoral arteries stimulated to contract with a solution containing 20 mM K+ and 200 nM Bay K 8644 (20 K/Bay K or with one containing 80 mM K+(80 K.Results. Incubation of arteries with M-β-CD (5 mM, 60 min increased force in response to 20 K/Bay K but not that induced by 80 K. Application of cholesterol saturated M-β-CD (Ch-MCD, 5 mM, 50 min reversed the effects of M-β-CD. After mechanical removal of endothelial cells M-β-CD caused only a small enhancement of contractions to 20 K/Bay K. This result suggests M-β-CD acts via altering release of an endothelial-derived vasodilator or vasoconstrictor. When nitric oxide synthase was blocked by pre-incubation of arteries with L-NAME (250 µM the contraction of arteries to 20 K/Bay K was enhanced, and this effect was abolished by pre-treatment with M-β-CD. This suggests M-β-CD is inhibiting endothelial NO release. Inhibition of large conductance voltage- and Ca2+-activated (BKCa channels with 2 mM TEA+ or 100 nM Iberiotoxin (IbTX enhanced 20 K/Bay K contractions. L-NAME attenuated the contractile effect of IbTX, as did endothelial removal.Conclusions. Our results suggest caveolar disruption results in decreased release of endothelial-derived nitric oxide in rat femoral artery, resulting in a reduced contribution of BKCa channels to the smooth muscle cell membrane potential, causing depolarisation and contraction.

  6. Circulating Concentrations of Adipocytokines and Their Receptors in the Isolated Corpus Cavernosum and Femoral Artery from Trained Rats on a High-Fat Diet.

    Science.gov (United States)

    Sponton, Amanda C S; Silva, Fábio H; Araujo, Hygor N; Valgas da Silva, Carmem P; de Moraes, Camila; Antunes, Edson; Zanesco, Angelina; Delbin, Maria A

    2017-01-01

    The aim of the present study was to evaluate different signaling pathways by which exercise training would interfere in endothelial function in obesity. Therefore, we examined adipocytokine levels and their receptors in the corpus cavernosum and femoral artery from trained rats on a high-fat diet. Functional experiments were performed in control sedentary and trained rats, and sedentary (h-SD) and trained male Wistar rats on a high-fat diet (h-TR). Nitric oxide (NO) and reactive oxygen species (ROS) were evaluated in vascular tissue. Circulating adipocytokines and their receptors were analyzed. In the h-SD group, the maximal responses to acetylcholine (ACh) were reduced in the femoral artery and corpus cavernosum as well as the electrical field stimulation, accompanied by an increase in circulating insulin, leptin, TNF-α, MCP-1, and PAI-1. Downregulation of ObR protein expression in the femoral artery was observed without alterations in AdipoR1 and TNFR1 in both preparations. A positive effect was observed in the h-TR group regarding the relaxation response to ACh and circulating adipocytokines, resulting in increased NO production and reduced ROS generation. Exercise restored the ObR protein expression only in the femoral artery. Aerobic exercise training ameliorated the inflammatory adipocytokines and restored the relaxation responses in the corpus cavernosum and femoral artery in rats on a high-fat diet. © 2017 S. Karger AG, Basel.

  7. Measuring the Pressure in the Superficial Inferior Epigastric Vein to Monitor for Venous Congestion in Deep Inferior Epigastric Artery Perforator Breast Reconstructions : A Pilot Study

    NARCIS (Netherlands)

    Smit, Jeroen M.; Audolfsson, Thorir; Whitaker, Iain S.; Werker, Paul M. N.; Acosta, Rafael; Liss, Anders G.

    2010-01-01

    During deep inferior epigastric artery perforator (DIEP) flap dissection, we noted that in many cases the superficial vein on the ipsilateral side of the flap was engorged and tense, and in others, it was empty. This led us to believe that the pressure is increased as the result of preferential outf

  8. Comparison of ultrasound-guided thrombin injection and compression repair in treatment of iatrogenic femoral arterial pseudoaneurysms

    Institute of Scientific and Technical Information of China (English)

    QIN Jun; GAO Yun-hua; ZHUO Zhong-xiong; HUANG Lan; LI Ai-min; SONG Yao-ming; JIN Jun; YU Xue-jun; GENG Zhao-hua; ZHOU Xia-bo; LIN Chun-mei

    2006-01-01

    Objective:To retrospectively compare the efficacy and safety of ultrasound-guided thrombin injection (UGTI) with ultrasound-guided compression repair (UGCR) in patients with postcatheterizational femoral arterial pseudoaneurysms (PSA). Methods: Thirty patients of this iatrogenic PSA [8males, 22 females, average age (66.5± 5.2) years] in our nstitution from 1997 to 2004 were retrospectively analyzed. Among them, 11 patients were treated with UGCR, 2 under continuous ultrasonographic (US) guidance and 9 under the guidance of femoral arterial bruit auscultation and dorsalis pedis artery palpation. Because UGCR was failed in 5 patients, consecutively 24 patients were treated with UGTI. Wine thrombin solution at a concentration of 200 U/ml was injected percutaneously using 22-25 gauge needles under color Doppler US. Demographics, clinical variables, pseudoaneurysm characteristics, and results of the 2 groups were compared by using Fisher's exact test and Student's t test. Results: The initial success rate of UGCR was 36.4% (4/11) nd the overall success rate was 45.5% (5/11). Ten of 11 patients suffered from local pain during the compression, but there was no any complication in UGTI group. The average dose of injected thrombin was (180±82) U for PSA of a single loculus and (315±150) U for multiloculated PSA. The initial success rate of UGTI was 89.5% (17/19) and the verall uccess rate was 100% (24/24). Conclusion:UGTI offers a safe, quick and effective means of definitively treating femoral pseudoaneurysms and seems superior to UGCR. The amount of thrombin applied on our people seems smaller compared with others' work.

  9. Improvement in cerebral hemodynamic parameters and outcomes after superficial temporal artery-middle cerebral artery bypass in patients with severe stenoocclusive disease of the intracranial internal carotid or middle cerebral arteries.

    Science.gov (United States)

    Low, Shiong Wen; Teo, Kejia; Lwin, Sein; Yeo, Leonard L L; Paliwal, Prakash R; Ahmad, Aftab; Sinha, Arvind K; Teoh, Hock Luen; Wong, Lily Y H; Chong, Vincent F; Seet, Raymond C S; Chan, Bernard P L; Yeo, Tseng Tsai; Chou, Ning; Sharma, Vijay K

    2015-09-01

    Both the older and the recent extracranial-intracranial (EC-IC) bypass trials for symptomatic carotid occlusion failed to demonstrate a reduction in stroke recurrence. However, the role of superficial temporal artery (STA)-middle cerebral artery (MCA) bypass in patients with symptomatic intracranial stenoocclusive disease has been rarely evaluated. The authors evaluated serial changes in various cerebral hemodynamic parameters in patients with severe stenoocclusive disease of the intracranial internal carotid artery (ICA) or middle cerebral artery (MCA) and impaired cerebral vasodilatory reserve (CVR), treated by STA-MCA bypass surgery or medical treatment. Patients with severe stenoocclusive disease of the intracranial ICA or MCA underwent transcranial Doppler (TCD) ultrasonography and CVR assessment using the breath-holding index (BHI). Patients with impaired BHI (hemodynamic parameters and reduction in stroke recurrence.

  10. Femoral artery thrombosis after internal fixation of a transverse acetabular fracture in a patient with osteogenesis imperfecta type I

    Directory of Open Access Journals (Sweden)

    Morgan Steven J

    2008-01-01

    Full Text Available Abstract Osteogenesis imperfecta is a genetic disorder characterized by increased susceptibility to fractures and vascular injuries due to connective tissue fragility. In this case report, we present a patient with osteogenesis imperfecta type I who sustained a transverse fracture of the right acetabulum while transferring from bed to chair. The fracture was repaired through an ilioinguinal approach. During the surgery, an iatrogenic injury to the femoral artery and vein occurred. This intraoperative complication was salvaged by immediate vascular repair. We discuss the possible causes of iatrogenic vascular injuries in patients with osteogenesis imperfecta. Orthopaedic surgeons should be aware of this potentially devastating complication in this particular patient cohort.

  11. The Fate and Distribution of Autologous Bone Marrow Mesenchymal Stem Cells with Intra-Arterial Infusion in Osteonecrosis of the Femoral Head in Dogs

    Directory of Open Access Journals (Sweden)

    Hongting Jin

    2016-01-01

    Full Text Available This study aimed to investigate if autologous bone marrow mesenchymal stem cells (MSCs could treat osteonecrosis of the femoral head (ONFH and what the fate and distribution of the cells are in dogs. Twelve Beagle dogs were randomly divided into two groups: MSCs group and SHAM operated group. After three weeks, dogs in MSCs group and SHAM operated group were intra-arterially injected with autologous MSCs and 0.9% normal saline, respectively. Eight weeks after treatment, the necrotic volume of the femoral heads was significantly reduced in MSCs group. Moreover, the trabecular bone volume was increased and the empty lacunae rate was decreased in MSCs group. In addition, the BrdU-positive MSCs were unevenly distributed in femoral heads and various vital organs. But no obvious abnormalities were observed. Furthermore, most of BrdU-positive MSCs in necrotic region expressed osteocalcin in MSCs group and a few expressed peroxisome proliferator-activated receptor-γ (PPAR-γ. Taken together, these data indicated that intra-arterially infused MSCs could migrate into the necrotic field of femoral heads and differentiate into osteoblasts, thus improving the necrosis of femoral heads. It suggests that intra-arterial infusion of autologous MSCs might be a feasible and relatively safe method for the treatment of femoral head necrosis.

  12. Intraoperative dexmedetomidine and postoperative cerebral hyperperfusion syndrome in patients who underwent superficial temporal artery-middle cerebral artery anastomosis for moyamoya disease

    Science.gov (United States)

    Seo, Hyungseok; Ryu, Ho-Geol; Son, Je Do; Kim, Jeong-Soo; Ha, Eun Jin; Kim, Jeong-Eun; Park, Hee-Pyoung

    2016-01-01

    Abstract Dexmedetomidine, a selective α2-agonist, reduces cerebral blood flow and has neuroprotective effects against cerebral ischemia/reperfusion injury in experimental animals. We examined whether intraoperative dexmedetomidine would reduce the incidence of postoperative cerebral hyperperfusion syndrome (CHS) after superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis in patients with moyamoya disease. The electronic medical records of 117 moyamoya patients who underwent STA-MCA anastomosis were reviewed retrospectively. The patients were divided into 2 groups: 48 patients received intraoperative dexmedetomidine (Group D), while 69 patients did not (Group ND). The incidence (primary outcome), onset, and duration of postoperative CHS were noted. The incidence of postoperative CHS was 45.8% and 40.6% in groups D and ND, respectively (P = 0.708). The duration of postoperative CHS was shorter in group D than in group ND (median [Q1–Q3], 5 [3–7] vs 8 [5–10] days, P = 0.021). There was no significant difference in the onset of CHS between group D and group ND (0 [0–2] vs 1 [0–3] days, P = 0.226). In conclusion, intraoperative dexmedetomidine did not reduce the incidence of postoperative CHS, although it reduced the duration of CHS, in patients who had undergone direct revascularization surgery for moyamoya disease. PMID:28033272

  13. Long-term patency of superficial temporal artery to middle cerebral artery bypass for cerebral atherosclerotic disease: factors determining the bypass patent.

    Science.gov (United States)

    Matano, Fumihiro; Murai, Yasuo; Tateyama, Kojiro; Tamaki, Tomonori; Mizunari, Takayuki; Matsukawa, Hideoshi; Teramoto, Akira; Morita, Akio

    2016-10-01

    Long-term patency of superficial temporal artery to middle cerebral artery (STA-MCA) bypass surgery for atherosclerotic disease and associated risk factors for loss of patency have rarely been discussed. We retrospectively analyzed long-term patency following STA-MCA bypass and evaluated various demographic and clinical factors to identify the ones predictive of postsurgical loss of patency using records of 84 revascularization procedures (58 patients, 45 males; mean age at surgery 63.6 years, range 31-78 years). Bypass patency was diagnosed based on magnetic resonance angiography or three-dimensional computed tomography. The mean follow-up period was 24.7 months (range 6-63 months). Decreased bypass patency was observed in 4 of 58 patients (6.9 %) who collectively underwent 6 bypasses (7.1 %) of 84. All cases of decreased bypass patency were first detected within 6 months of surgery. Bypass patency was not correlated with age, sex, number of anastomoses, postoperative cerebral infarction, or control of postoperative diabetes mellitus. We found a significant association of bypass patency with hyperperfusion (p = 0.01) and postoperative smoking (p = 0.0036). Furthermore, we found a significant association of hyperperfusion with STA diameter (p bypass patency in cerebral atherosclerotic disease patients. Careful monitoring of patency to prevent hyperperfusion and cessation of smoking are recommended, particularly within 6 months of the surgery.

  14. Mechanisms Underlying Enhanced Noradrenaline-Induced Femoral Arterial Contractions of Spontaneously Hypertensive Rats: Involvement of Endothelium-Derived Factors and Cyclooxygenase-Derived Prostanoids.

    Science.gov (United States)

    Matsumoto, Takayuki; Watanabe, Shun; Iguchi, Maika; Ando, Makoto; Oda, Mirai; Nagata, Mako; Yamada, Kosuke; Taguchi, Kumiko; Kobayashi, Tsuneo

    2016-01-01

    We investigated the relationship between noradrenaline (NAd)-induced contractions, endothelial function, and hypertension in femoral arteries isolated from spontaneously hypertensive rats (SHR). In the femoral arteries of SHR, vs. age-matched control Wistar Kyoto (WKY) rats, contractions induced by NAd were increased. These effects were enhanced by endothelial denudation, which abolished the differences between the two groups. NAd-induced contractions were enhanced by nitric oxide (NO) synthase inhibition, and further increased by the blockade of endothelium-derived hyperpolarizing factor (EDHF). Conversely, NAd-induced contractions were inhibited by cyclooxygenase (COX) inhibition. In addition, in SHR arteries, acetylcholine-induced relaxation was reduced, and components of endothelium-derived factors were altered, such as increased COX-derived vasoconstrictor prostanoids, reduced EDHF, and preserved NO-mediated relaxation. In the femoral arteries of SHR, the production of prostanoids [6-keto prostaglandin (PG)F1α (a metabolite of prostacyclin (PGI2), PGE2, and PGF2α] and COX-2 protein were increased compared with that in WKY rats. By contrast, contractions induced by beraprost (a stable PGI2 analogue), PGE2, and U46619 (thromboxane/prostanoid receptor agonist) were similar between the SHR and WKY groups. Thus, NAd-induced femoral arterial contractions are augmented in SHR resulting from endothelial dysfunction and increased COX-derived vasoconstrictor prostanoid levels.

  15. Skeletal muscle perfusion and stem cell delivery in muscle disorders using intra-femoral artery canulation in mice.

    Science.gov (United States)

    Matthias, Nadine; Hunt, Samuel D; Wu, Jianbo; Darabi, Radbod

    2015-11-15

    Muscular dystrophies are among major inherited muscle disorders characterized by progressive muscle damage and fibrosis with no definitive cure. Recently, gene or cell based therapies have been developed to restore the missing gene expression or replace the damaged tissues. In order to test the efficiency of these therapies in mice models of muscular dystrophies, the arterial route of delivery is very advantageous as it provides uniform muscle exposure to the therapeutic agents or cells. Although there are few reports of arterial delivery of the therapeutic agents or cells in mice, there is no in-depth description and evaluation of its efficacy in perfusion of downstream muscles. This study is aimed to develop a practical method for intra-femoral artery perfusion in mice and to evaluate perfusion efficiency using near-infrared-fluorescence (NIRF) imaging as well as histology following stem cell delivery. Our results provide a practical guide to perform this delicate method in mice. By using a sensitive fluorescent dye, different muscle groups of the hindlimb have been evaluated for proper perfusion. As the final step, we have validated the efficiency of arterial cell delivery into muscles using human iPS-derived myogenic cells in an immunodeficient mouse model for Duchenne muscular dystrophy (NSG-mdx(4cv)).

  16. Quantitative cerebral perfusion assessment using microscope-integrated analysis of intraoperative indocyanine green fluorescence angiography versus positron emission tomography in superficial temporal artery to middle cerebral artery anastomosis

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    Shinya Kobayashi

    2014-01-01

    Full Text Available Background: Intraoperative qualitative indocyanine green (ICG angiography has been used in cerebrovascular surgery. Hyperperfusion may lead to neurological complications after superficial temporal artery to middle cerebral artery (STA-MCA anastomosis. The purpose of this study is to quantitatively evaluate intraoperative cerebral perfusion using microscope-integrated dynamic ICG fluorescence analysis, and to assess whether this value predicts hyperperfusion syndrome (HPS after STA-MCA anastomosis. Methods: Ten patients undergoing STA-MCA anastomosis due to unilateral major cerebral artery occlusive disease were included. Ten patients with normal cerebral perfusion served as controls. The ICG transit curve from six regions of interest (ROIs on the cortex, corresponding to ROIs on positron emission tomography (PET study, was recorded. Maximum intensity (I MAX , cerebral blood flow index (CBFi, rise time (RT, and time to peak (TTP were evaluated. Results: RT/TTP, but not I MAX or CBFi, could differentiate between control and study subjects. RT/TTP correlated (|r| = 0.534-0.807; P < 0.01 with mean transit time (MTT/MTT ratio in the ipsilateral to contralateral hemisphere by PET study. Bland-Altman analysis showed a wide limit of agreement between RT and MTT and between TTP and MTT. The ratio of RT before and after bypass procedures was significantly lower in patients with postoperative HPS than in patients without postoperative HPS (0.60 ± 0.032 and 0.80 ± 0.056, respectively; P = 0.017. The ratio of TTP was also significantly lower in patients with postoperative HPS than in patients without postoperative HPS (0.64 ± 0.081 and 0.85 ± 0.095, respectively; P = 0.017. Conclusions: Time-dependent intraoperative parameters from the ICG transit curve provide quantitative information regarding cerebral circulation time with quality and utility comparable to information obtained by PET. These parameters may help predict the occurrence of postoperative

  17. Stent graft repair of iatrogenic femoral arteriovenous fistula: a useful therapeutic approach in a hostile groin.

    Science.gov (United States)

    De Martino, Randall R; Nolan, Brian W; Powell, Richard J; Walsh, Daniel B; Stone, David H

    2010-01-01

    The incidence of iatrogenic femoral arteriovenous fistulas (IFAVF) has increased in contemporary practice. We herein report the case of a 55-year-old obese woman with significant surgical comorbidities who sustained an IFAVF between the superficial femoral artery (SFA) and the femoral vein. Given her substantial risk factors, she was treated with a SFA stent-graft (iCast 6 x 22 mm) using a contralateral endovascular approach. She remains asymptomatic at 15 months with ongoing resolution of the AVF. This report highlights the utility of stent-graft repair of an IFAVF in high surgical risk patients or in those with ''hostile'' anatomy.

  18. Thermochemoradiation Therapy Using Superselective Intra-arterial Infusion via Superficial Temporal and Occipital Arteries for Oral Cancer With N3 Cervical Lymph Node Metastases

    Energy Technology Data Exchange (ETDEWEB)

    Mitsudo, Kenji, E-mail: mitsudo@yokohama-cu.ac.jp [Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama (Japan); Koizumi, Toshiyuki; Iida, Masaki; Iwai, Toshinori; Oguri, Senri [Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama (Japan); Yamamoto, Noriyuki [Department of Oral and Maxillofacial Surgery, Nagoya University Graduate School of Medicine, Nagoya (Japan); Itoh, Yoshiyuki [Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya (Japan); Kioi, Mitomu; Hirota, Makoto; Tohnai, Iwai [Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama (Japan)

    2012-08-01

    Purpose: To evaluate the therapeutic results and histopathological effects of treatment with thermochemoradiation therapy using superselective intra-arterial infusion via the superficial temporal and occipital arteries for N3 cervical lymph node metastases of advanced oral cancer. Methods and Materials: Between April 2005 and September 2010, 9 patients with N3 cervical lymph node metastases of oral squamous cell carcinoma underwent thermochemoradiation therapy using superselective intra-arterial infusion with docetaxel (DOC) and cisplatin (CDDP). Treatment consisted of hyperthermia (2-8 sessions), superselective intra-arterial infusions (DOC, total 40-60 mg/m{sup 2}; CDDP, total 100-150 mg/m{sup 2}) and daily concurrent radiation therapy (total, 40-60 Gy) for 4-6 weeks. Results: Six of 9 patients underwent neck dissection 5-8 weeks after treatment. In four of these 6 patients, all metastatic lymph nodes, including those at N3, were grade 3 (non-viable tumor cells present) or grade 4 (no tumor cells present) tumors, as classified by the system by Shimosato et al (Shimosato et al Jpn J Clin Oncol 1971;1:19-35). In 2 of these 6 patients, the metastatic lymph nodes were grade 2b (destruction of tumor structures with a small amount of residual viable tumor cells). The other 3 patients did not undergo neck dissection due to distant metastasis after completion of thermochemoradiation therapy (n=2) and refusal (n=1). The patient who refused neck dissection underwent biopsy of the N3 lymph node and primary sites and showed grade 3 cancer. During follow-up, 5 patients were alive without disease, and 4 patients died due to pulmonary metastasis (n=3) and noncancer-related causes (n=1). Five-year survival and locoregional control rates were 51% and 88%, respectively. Conclusions: Thermochemoradiation therapy using intra-arterial infusion provided good histopathologic effects and locoregional control rates in patients with N3 metastatic lymph nodes. However, patients with N3

  19. A Case of Urethral Reconstruction Using a Superficial Circumflex Iliac Artery

    Directory of Open Access Journals (Sweden)

    Kun-Woon Yoo

    2012-05-01

    Full Text Available A radial forearm free flap has been conventionally used for urethral reconstruction. However,aesthetic and functional complications occur frequently at the donor site. The use of asuperficial circumflex iliac artery perforator (SCIP flap can resolve these disadvantages.Here, we report our case with a review of literature. A 69-year-old man visited our hospitalwith multiple contusions of the abdomen and genital amputation. After necrotic tissuedebridement, the length of the residual corpus carvernosum was 1.5 cm and that of thecorpus spongiosum and urethra was 1 cm. For the reconstruction of the penis, a SCIP flap andanterolateral thigh free flap was performed. The primary closure was performed at the donorsite. Three weeks postoperatively, the patient had a urethral foley catheter removed. Theneourethra was functioning well without stricture. Four months postoperatively, the patienthad no complications such as urethral stricture. A good recovery was also achieved withno aesthetic deficits at the donor site. SCIP flap is appropriate for urethral reconstruction.Because of its proximity to the recipient sites, it makes surgical preparation easier and theprimary closure at the donor site available. It is also advantageous in that its location isalmost unnoticeable.

  20. An ultrasound-based method for determining pulse wave velocity in superficial arteries.

    Science.gov (United States)

    Rabben, Stein Inge; Stergiopulos, Nikos; Hellevik, Leif Rune; Smiseth, Otto A; Slørdahl, Stig; Urheim, Stig; Angelsen, Bjørn

    2004-10-01

    In this paper, we present a method for estimating local pulse wave velocity (PWV) solely from ultrasound measurements: the area-flow (QA) method. With the QA method, PWV is estimated as the ratio between change in flow and change in cross-sectional area (PWV = dQ/dA) during the reflection-free period of the cardiac cycle. In four anaesthetized dogs and 21 human subjects (age 23-74) we measured the carotid flow and cross-sectional area non-invasively by ultrasound. As a reference method we used the Bramwell-Hill (BH) equation which estimates PWV from pulse pressure and cross-sectional area. Additionally, we therefore measured brachial pulse pressure by oscillometry in the human subjects, and central aortic pulse pressure by micro-manometry in the dogs. As predicted by the pressure dependency of arterial stiffness, the estimated PWV decreased when the aortic pressure was lowered in two of the dogs. For the human subjects, the QA and BH estimates were correlated (R=0.43, pBH method increased with age (pBH method, indicating different precisions for the two methods. This study illustrates that the simple equation PWV = dQ/dA gives estimates correlated to the PWV of the reference method. However, improvements in the basic measurements seem necessary to increase the precision of the method.

  1. Personalized Antiplatelet Therapy Following Endovascular Revascularization in Peripheral Artery Occlusive Disease : A Novel Concept

    NARCIS (Netherlands)

    Peeters Weem, S. M O; Leunissen, T. C.; Teraa, M.; Vonken, E. J.; De Borst, G. J.; Moll, F. L.

    2015-01-01

    Case A 73 year old patient with a longstanding history of peripheral artery occlusive disease (PAOD) presented with an acute on chronic progression of symptoms, based on a long occlusion of the superficial femoral artery (SFA), which was treated by thrombosuction, percutaneous transluminal

  2. Children and Adolescent Obesity Associates with Pressure-Dependent and Age-Related Increase in Carotid and Femoral Arteries’ Stiffness and Not in Brachial Artery, Indicative of Nonintrinsic Arterial Wall Alteration

    Directory of Open Access Journals (Sweden)

    Victoria García-Espinosa

    2016-01-01

    Full Text Available Aim. To analyze if childhood obesity associates with changes in elastic, transitional, and/or muscular arteries’ stiffness. Methods. 221 subjects (4–15 years, 92 females were assigned to normal weight (NW, n=137 or obesity (OB, n=84 groups, considering their body mass index z-score. Age groups were defined: 4–8; 8–12; 12–15 years old. Carotid, femoral, and brachial artery local stiffness was determined through systodiastolic pressure-diameter and stress-strain relationships. To this end, arterial diameter and peripheral and aortic blood pressure (BP levels and waveforms were recorded. Carotid-femoral, femoropedal, and carotid-radial pulse wave velocities were determined to evaluate aortic, lower-limb, and upper-limb regional arterial stiffness, respectively. Correlation analysis between stiffness parameters and BP was done. Results. Compared to NW, OB subjects showed higher peripheral and central BP and carotid and femoral stiffness, reaching statistical significance in subjects aged 12 and older. Arterial stiffness differences disappeared when levels were normalized for BP. There were no differences in intrinsic arterial wall stiffness (elastic modulus, BP stiffness relationships, and regional stiffness parameters. Conclusion. OB associates with BP-dependent and age-related increase in carotid and femoral (but not brachial stiffness. Stiffness changes would not be explained by intrinsic arterial wall alterations but could be associated with the higher BP levels observed in obese children.

  3. From arteritis to mycotic aneurysm: visualization of the progression of mycotic aneurysm development following femoral arterial line insertion in an infant

    Energy Technology Data Exchange (ETDEWEB)

    Beck-Razi, Nira [Israel Institute of Technology, Department of Medical Imaging, The Rappaport Faculty of Medicine, Technion, Haifa (Israel); Rambam Medical Center, Department of Medical Imaging, Haifa (Israel); Bar-Joseph, Gad [Israel Institute of Technology, Pediatric Critical Care Unit, The Rappaport Faculty of Medicine, Technion, Haifa (Israel); Ofer, Amos; Gaitini, Diana [Israel Institute of Technology, Department of Medical Imaging, The Rappaport Faculty of Medicine, Technion, Haifa (Israel); Hoffman, Aharon [Israel Institute of Technology, Department of Vascular Surgery, Rambam Health Care Center, The Rappaport Faculty of Medicine, Technion, Haifa (Israel)

    2010-12-15

    Although uncommon, mycotic aneurysms in infants can be lethal because of the high risk of rapid expansion and rupture. Most catheter-associated mycotic aneurysms reported in the first year of life develop following umbilical artery catheterizations. We describe the sonographic detection of an early stage mycotic aneurysm in a 4-month-old following femoral artery catheterization complicated by methicillin-resistant Staphylococcus aureus (MRSA) septicemia. We also describe the sonographic and radiographic progression of this mycotic aneurysm before surgery. (orig.)

  4. Coaxial electrospinning of P(LLA-CL)/heparin biodegradable polymer nanofibers: potential vascular graft for substitution of femoral artery.

    Science.gov (United States)

    Zhai, Wei; Qiu, Li-Jun; Mo, Xiu-Mei; Wang, Sheng; Xu, Yun-Fei; Peng, Bo; Liu, Min; Huang, Jun-Hua; Wang, Guang-Chun; Zheng, Jun-Hua

    2013-06-07

    Electrospinning is one of the most simple and effective methods to prepare polymer fibers with the diameters ranging from nanometer to several micrometers. Poly(L-lactide)-co-poly (ɛ-caprolactone) (P(LLA-CL)) fibers and P(LLA-CL)/heparin coaxial composite fibers herein were successfully prepared by single electrospinning and coaxial electrospinning, respectively. The prepared endothelialized P(LLA-CL) and P(LLA-CL)/heparin vascular grafts were used in the Beagle dogs experiment to evaluate the feasibility of thus made different scaffolds for substitution of dog femoral artery in early period, medium term, and long term, meanwhile the pure P(LLA-CL) vascular graft was used as the control group during all the experiments. The animal model was established by using the graft materials to anastomose both femoral arteries of dogs. The vascular grafts patency rates (i.e., the unobstructed capacity of blood vessel) were detected by color Doppler flow imaging technology and digital subtraction angiography. To observe the histological morphology at different periods, the vascular grafts were removed after 7, 14, and 30 days, and the corresponding histological changes were evaluated by hematoxylin and eosin staining. The experimental results show that in the early period, the patency rates of pure P(LLA-CL) graft, endothelial P(LLA-CL) graft, and P(LLA-CL)/heparin graft were 75%, 75%, and 100%, respectively; in the medium term, the patency rates of pure P(LLA-CL) graft and endothelial P(LLA-CL) graft were 25%, whereas that of P(LLA-CL)/heparin graft was 50%; the patency rates of pure P(LLA-CL) graft and endothelial P(LLA-CL) graft were down to 0%, whereas the patency rate of P(LLA-CL)/heparin graft was 25% in the long term. This preliminary study has demonstrated that P(LLA-CL)/heparin coaxial composite fiber maybe a reliable artificial graft for the replacement of femoral artery. © 2013 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2013.

  5. Safety and efficacy of femoral artery closure with the FemoSeal(R) device after coronary angiography using a 7 French sheath.

    Science.gov (United States)

    Wanitschek, M M; Suessenbacher, A; Dörler, J; Pachinger, O; Moes, N; Alber, H F

    2011-09-01

    Post-cardiac catheterization femoral artery hemostasis can be accomplished with several mechanisms, including the FemoSeal® hemostasis device which has been designed and approved for closure of 6 French (F) arterial puncture sites. The aim of this study was to investigate whether the FemoSeal® vascular closure device can effectively and safely seal 7F arterial puncture sites after diagnostic and interventional cardiac catheterizations. Femoral artery puncture sites of 50 consecutive patients undergoing cardiac catheterization were closed with the FemoSeal® vascular closure device, according to the manufacturer's instructions. Efficacy endpoints were time to hemostasis and successful ambulation. Safety endpoints included bleeding complications, vessel occlusion and pseudoaneurysms. Mean time to hemostasis was 57.8±26.3 seconds (0-125 seconds). Hemostasis was achieved in 100 percent of the 50 patients. One patient suffered minor bleeding the next day, i.e. local hematoma. This clinical study demonstrates that the FemoSeal® vascular closure device, initially approved for closure of 6F arterial puncture sites, shows promising efficacy and safety to seal a larger (7F) femoral arterial puncture sites after diagnostic and interventional cardiac catheterizations.

  6. The Efficacy of Single Barrel Superficial Temporal Artery-middle Cerebral Artery Bypass in Treatment of Adult Patients with Ischemic-type Moyamoya Disease

    Science.gov (United States)

    Ha, Mahnjeong; Choi, Chang Hwa; Lee, Jae Il; Cha, Seung Heon; Lee, Sang Weon

    2016-01-01

    Objective So far, there is no study answering the question of which type of surgical technique is practically the most useful in the treatment of adult patients with ischemic type moyamoya disease (MMD). We evaluated the efficacy of single barrel superficial temporal artery (STA)-middle cerebral artery (MCA) bypass in the treatment of adult patients with ischemic type MMD by retrospectively collecting clinical and radiological data. Materials and Methods A retrospective review identified 31 adult patients who underwent 43 single barrel STA-MCA bypass procedures performed for treatment of ischemic-type MMD between 2006 and 2014. The male to female ratio was 17:14 and the mean age was 41 years (range, 21-65 years). Peri-operative complications, angiographic and clinical outcomes were analyzed retrospectively. Results The permanent neurological morbidity and mortality rates were 2.3% and 0%, respectively. During the observation period of a mean of 35 months (range, 12-73 months), 29 patients (93.5%) had no further cerebrovascular events and transient ischemic attack occurred in two patients (6.5%), resulting in an annual stroke risk of 2.2%. Follow-up computed tomography perfusion (CTP) (mean, 18.4 months after surgery) documented improved cerebral hemodynamics in the revascularized hemispheres (p < 0.001). Post-operative patency was clearly verified in 38 bypasses (88.4%) of 43 bypasses on follow-up imaging (mean, 16.5 months). Conclusion Our results suggest that single barrel STA-MCA bypass with wide dural opening is safe and durable method of cerebral revascularization in adult patients with ischemic type MMD and can be considered as a potential treatment option for adult patients with ischemic type MMD. PMID:27847768

  7. Laser Doppler flowmeter study on regional cerebral blood flow in early stage after standard superficial temporal artery-middle cerebral artery bypass surgery for moyamoya disease

    Institute of Scientific and Technical Information of China (English)

    GESANG Dun-zhu; ZHANG Dong; ZHAO Ji-zong; WANG Shuo; ZHAO Yuan-li; WANG Rong; SUN Jian-jun; MENG Ze

    2009-01-01

    Background Standard superficial temporal artery-middle cerebral artery (STA-MCA) bypass surgery is an effective treatment for moyamoya disease, but recent evidence suggests that postoperative cerebral hyperperfusion can occur. In this study, the trendline of changes in regional cerebral blood flow (rCBF) after surgery were continually monitored near the site of anastomosis in order to investigate both the efficacy of the procedure for improving rCBF and the possible riskof hyperperfusion.Methods Standard STA-MCA bypass surgery was performed on 13 patients, rCBF was measured continually using laser Doppler flowmetry (LDF) until the 5th day after the operation with the LDF probe implanted adjacent to the area of the anastomosis. The trendline of rCBF changes postoperatively was recorded for the analysis performed using SPSS 13.0.Results The baseline LDF value of cortical rCBF was (84.68±14.39) perfusion unit (PU), which was linear relative to absolute perfusion volume before anastomosis and (88.90±11.26) PU immediately after anastomosis (P >0.05). The value changed significantly from before to after anastomosis (P 0.05).Conclusions STA-MCA anastomosis improves the cerebral blood supply significantly in the early stage after surgery,however, the risk of symptomatic hyperperfusion may exist, which may possibly occur on the 1st day and 5th day after surgery. A LDF is useful for postoperative monitoring for both the efficacy of bypass and possible risk of neurologic deterioration or bleeding from hyperperfusion.

  8. Effects of KRN4884, a novel K+ channel opener, on ionic currents in rabbit femoral arterial myocytes.

    Science.gov (United States)

    Muraki, Katsuhiko; Sasaoka, Akiko; Ohya, Susumu; Watanabe, Minoru; Imaizumi, Yuji

    2003-11-01

    Effects of KRN4884 (5-amino-N-[2-(2-chlorophenyl)ethyl]-N'-cyano-3-pyridinecarboxamidine), a novel K(+) channel opener, on ionic currents were examined in rabbit femoral arterial myocytes (RFAMs). Under whole-cell clamp conditions where cells were superfused with 5.9 mM K(+) bathing solution, KRN4884 elicited an outward current at -30 mV. KRN4884-induced current had a reversal potential of -78 mV and was abolished by application of glibenclamide (glib). KRN4884 was approximately 43 times more potent than levcromakalim in activating an ATP-sensitive K(+) current (I(K-ATP)). On the other hand, KRN4884 affected neither voltage-dependent Ca(2+) nor delayed rectifier K(+) channel currents. In the inside-out patch clamp configuration where cells were superfused with the symmetrical 140 mM K(+) solution, KRN4884 activated 47 pS K(+) channels in the presence of adenosine diphosphate. Similar 47 pS K(+) channels, which were reversibly inhibited by glib, were recorded under outside-out patch conditions. Using RT-PCR analysis, we found that inward rectifier K channel 6.1 (Kir6.1) and sulfonylurea 2B (SUR2B) transcripts were predominantly expressed in rabbit femoral artery. These results indicate that KRN4884 potently activates I(K-ATP) in RFAMs. The KRN4884-sensitive 47 pS K(+) channel activity underlying I(K-ATP) is a vascular type K(ATP) channel consisting of Kir6.1 and SUR2B and has similar characteristics to those of ATP-sensitive K(+) channels activated by K(+) channel openers in other types of smooth muscles.

  9. Efficacy of profound femoral artery revascularization on TASC type D arteriosclerosis obliterans%股深动脉优势供血治疗TASC D型动脉硬化下肢缺血的疗效分析

    Institute of Scientific and Technical Information of China (English)

    田轩; 刘建龙; 贾伟; 蒋鹏; 程志远; 张蕴鑫; 田晨阳

    2016-01-01

    目的:探讨髂动脉通畅的泛大西洋协作组织共识(TASC) D型动脉硬化下肢缺血的治疗方式,比较股浅动脉支架植入术与股深动脉成形术的疗效。方法回顾性地分析2007年1月至2010年12月北京积水潭医院血管外科收治的32例TASC D型下肢缺血患者临床资料,随机分为股浅动脉治疗组(行股浅动脉球囊扩张+支架植入术)16例和股深动脉治疗组16例,并进行对照分析。通过对比手术前后踝肱指数(ABI)、手术后3年截肢率及症状改善情况评价两种方法的疗效。结果两组患者术后ABI均明显高于术前(P<0.05);且股浅动脉治疗组术后ABI高于股深动脉治疗组(P<0.05)。两组3年后跛行距离<200米和行截肢手术患者比较,差异均无统计学意义(P>0.05)。结论髂动脉通畅的TASC D型动脉硬化下肢缺血患者,无论腔内股浅动脉支架植入术还是股深动脉成形术均可改善患者症状,增加肢体血供;股浅动脉支架植入对患者近期远端肢体血供改善优于股深动脉成形术。%ObjectiveTo compare the efficacy of revascularization of profoundfemoral arteryversus superficial femoral artery on TASC type D arteriosclerosis obliterans.MethodsClinical data of45 cases of TASC type D arteriosclerosis obliteransadmitted in our hospital from January 2007 to December 2010 were collected andretrospectively analyzed.Sixteen patients received endovascular balloon dilation combined with stent implantation into superficial femoral artery, and another 16 patients underwentsimilarrevascularizationbut into profoundfemoral artery. The efficacy variables including ankle-brachialindex(ABI), amputation rate in 3 yearsafter surgery, and the relief of symptoms were used to evaluate the efficacy of the 2 approachesinthe32cases.ResultsRevascularizationresulted in significant increases in ABI in the 2 groups (P0.05).ConclusionForthe patients with

  10. Assessment of Hyperperfusion by Brain Perfusion SPECT in Transient Neurological Deterioration after Superficial Temporal Artery-Middle Cerebral Artery Anastomosis Surgery

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Won; Kim, Yu Kyeong; Lee, Sang Mi; Eo, Jae Sun; Oh, Chang Wan; Lee, Won Woo; Paeng, Jin Chul; Kim, Sang Eun [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2008-08-15

    Transient neurological deterioration (TND) is one of the complications after extracranial-intracranial bypass surgery, and it has been assumed to be caused by postoperative transient hyperperfusion. This study was performed to evaluate the relationship between TND and preoperative and postoperative cerebral perfusion status on brain perfusion SPECT following superficial temporal artery.middle cerebral artery (STA-MCA) anastomosis surgery. A total of 60 STA-MCA anastomosis surgeries of 56 patients (mean age: 50{+-}16 yrs; M:F=29:27; atherosclerotic disease: 33, moyamoya disease: 27) which were done between September 2003 and July 2006 were enrolled. The resting cerebral perfusion and cerebral vascular reserve (CVR) after acetazolamide challenge were measured before and 10 days after surgery using 99mTc-ethylcysteinate dimer (ECD) SPECT. Moreover, the cerebral perfusion was measured on the third postoperative day. With the use of the statistical parametric mapping and probabilistic brain atlas, the counts for the middle cerebral artery (MCA) territory were calculated for each image, and statistical analyses were performed. In 6 of 60 cases (10%), TND occurred after surgery. In all patients, the preoperative cerebral perfusion of affected MCA territory was significantly lower than that of contralateral side (p=0.002). The cerebral perfusion on the third and tenth day after surgery was significantly higher than preoperative cerebral perfusion (p=0.001, p=0.02). In TND patients, basal cerebral perfusion and CVR on preoperative SPECT were significantly lower than those of non-TND patients (p=0.01, p=0.05). Further, the increases in cerebral perfusion on the third day after surgery were significant higher than those in other patients (p=0.008). In patients with TND, the cerebral perfusion ratio of affected side to contralateral side on third postoperative day was significantly higher than that of other patients (p=0.002). However, there was no significant difference of

  11. Two isoforms of cyclooxygenase contribute to augmented endothelium-dependent contractions in femoral arteries of 1-year-old rats

    Institute of Scientific and Technical Information of China (English)

    Yi SHI; Ricky YK MAN; Paul M VANHOUTTE

    2008-01-01

    Aim: The present experiments were designed to study the changes in endothe-lium-dependent contractions with aging. Methods: The rat femoral arteries of 20-week and 1-year-old rats with and without endothelium were suspended in organ chambers to record isometric tension. The production of oxygen-derived free radicals in the endothelium was measured with 2',7'-dichiorodihydrofluorescein diacetate (DCF) using confocal microscopy. Protein presences were determined by Western blotting. Results: In the arteries from the 1-year-old rats, endothe-lium-dependent relaxations to A23187 were reduced, but the endothelium-depen-dent contractions to A23187 (in the presence of Nω-nitro-L-arginine methyl ester hydrochloride [L-NAME; an inhibitor of nitric oxide synthase]) were augmented, demonstrating endothelial dysfunction with aging. Indomethacin normalized the responses, suggesting that a cyclooxygenase (COX)-dependent contraction is prominent in aging. The endothelium-dependent contractions were also prevented by terntroban (a blocker of thromboxane-prostanoid receptors), confirming the activation of thromboxane-prostanoid receptors on vascular smooth muscle. Valeryl salicylate and NS-398 (preferential inhibitors of COX-1 and COX-2, respectively) partially reduced the response, indicating that both COX-1 and COX-2 are involved. Western blotting confirmed the upregulation of both isoforms in the arteries of the 1-year-old rats. In the presence of L-NAME, A23187 increased the DCF fluores-cence in the endothelium, demonstrating that the production of oxygen-derived free radicals contributes to endothelium-dependent contractions. The activity of catalase was reduced in the arteries with endothelium of 1-year-old rats, indicating that hydrogen peroxide is the likely mediator of increased oxidative stress in the aging endothelium. Conclusion: Endothelium-dependent contractions are aug-mented with aging. Oxidative stress potentiates the response, and both COX-1 and COX-2 are

  12. [Embolism of the humeral artery originating in a thrombosed axillo-femoral bypass].

    Science.gov (United States)

    Barba, A; Escribano, J V; García-Alfageme, A

    1992-01-01

    A case of a patient, with acute arterial ischemia at the upper limb is reported. On this case, ischemia was caused by humeral arterial embolism. The embolic origin was focused on the proximal end of a thrombosed axillofemoral bypass. After a rude manipulation during surgical procedure, part of the thrombus, following the sanguineous current, occluded the humeral artery. Patient underwent an emergent surgery. Posterior course was good. Histology showed a re-epithelialized, ancient thrombus. Cardiologic studies and angiography showed no others embolic focuses.

  13. Routine Use of Fluoroscopic-Guided Femoral Arterial Puncture to Minimise Vascular Complication Rates in CTO Intervention: Multi-centre UK Experience.

    Science.gov (United States)

    Fairley, Sarah L; Lucking, Andrew J; McEntegart, Margaret; Shaukat, Aadil; Smith, David; Chase, Alexander; Hanratty, Colm G; Spratt, James C; Walsh, Simon J

    2016-12-01

    Chronic total occlusion (CTO) revascularisation has a crucial role in contemporary percutaneous coronary intervention (PCI). Procedural success is influenced by disease complexity, calcific burden and patient characteristics but has substantially improved with the implementation of novel hybrid strategies. However, vascular-access related complications remain a cause of morbidity and mortality. This study aimed to assess the effectiveness of fluoroscopic-guided femoral arterial puncture to minimise this risk during CTO PCI. Standardised data were retrospectively collected from four high-volume UK CTO centres between September 2011 and November 2013. Demographic, clinical and procedural data (vascular access site, sheath size, anticoagulation use) was collated. The anatomical location of the femoral puncture in relation to the femoral bifurcation, femoral head position and inferior epigastric artery were recorded. Adverse events related to vascular access were documented. A total of 528 patients were included (676 femoral punctures) with the majority being male (n=432, 81.8%). Large sheaths (8F) were used in 81.2% of cases. Fluoroscopy-enabled punctures were made in the 'safe zone' in over > 93% of cases. Vascular closure devices (VCD) were used in 88.3% of cases. The adverse event rate per puncture was 0.89%. This study demonstrates an extremely low incidence of vascular-access complications in CTO PCI when fluoroscopic guidance is used to obtain femoral arterial access by default radial operators. Copyright © 2016 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  14. Placing two parallel catheters by Seldinger`s approach through the femoral artery for CT angiography and CT during arterioportography. Evaluation of efficacy and safety

    Energy Technology Data Exchange (ETDEWEB)

    Saito, Kazuhiro; Goto, Yasuyuki; Saito, Toshitaka [Musashino Red Cross Hospital, Tokyo (Japan); Wakabayashi, Yukari; Abe, Kimihiko

    1998-02-01

    The purpose of this study was to evaluate the efficacy and safety of placing two parallel catheters by Seldinger`s approach through the femoral artery for CT angiography (CTA) and CT during arterioportography (CTAP). We performed an analysis of 30 patients. Two introducers were successfully placed in all cases. Only one minor complication was observed, a localized inguinal hematoma. The CTA/CTAP procedures were successful in all patients except six who had anatomical variations of the hepatic arterial supply. Our methods proved to be useful and safe for patients with standard hepatic arterial supply. (author)

  15. Combined aerobic and resistance exercise training decreases peripheral but not central artery wall thickness in subjects with type 2 diabetes.

    NARCIS (Netherlands)

    Schreuder, T.H.A.; Munckhof, I.C.L. van den; Poelkens, F.; Hopman, M.T.; Thijssen, D.H.

    2015-01-01

    OBJECTIVE: Little is known about the impact of exercise training on conduit artery wall thickness in type 2 diabetes. We examined the local and systemic impact of exercise training on superficial femoral (SFA), brachial (BA), and carotid artery (CA) wall thickness in type 2 diabetes patients and con

  16. Combined aerobic and resistance exercise training decreases peripheral but not central artery wall thickness in subjects with type 2 diabetes.

    NARCIS (Netherlands)

    Schreuder, T.H.A.; Munckhof, I.C.L. van den; Poelkens, F.; Hopman, M.T.; Thijssen, D.H.

    2015-01-01

    OBJECTIVE: Little is known about the impact of exercise training on conduit artery wall thickness in type 2 diabetes. We examined the local and systemic impact of exercise training on superficial femoral (SFA), brachial (BA), and carotid artery (CA) wall thickness in type 2 diabetes patients and

  17. The value of arterial pressure waveform cardiac output measurements in the radial and femoral artery in major cardiac surgery patients

    NARCIS (Netherlands)

    van Drumpt, A.; J. van Bommel (Jasper); S.E. Hoeks (Sanne); F. Grüne (Frank); T. Wolvetang (Timothy); J.A. Bekkers (Jos); M. Horst, ter (Maarten)

    2017-01-01

    textabstractBackground: A relatively new uncalibrated arterial pressure waveform cardiac output (CO) measurement technique is the Pulsioflex-ProAQT® system. Aim of this study was to validate this system in cardiac surgery patients with a specific focus on the evaluation of a difference in the radial

  18. Safety and efficacy of distal perfusion catheterization to prevent limb ischemia after common femoral artery cannulation for extracorporeal membrane oxygenation

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Chang Ho; Seong, Nak Jong; Yoon, Chang Jin [Dept. of Radiology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)

    2016-06-15

    The extracorporeal membrane oxygenation (ECMO) cannula has the potential for obstructing flow to the lower limb, thus causing severe ischemia and possible limb loss. We evaluated the safety and clinical efficacy of percutaneous distal perfusion catheterization in preventing limb ischemia. Between March 2013 and February 2015, 28 patients with distal perfusion catheterization after ECMO were included in this retrospective study. The technical success was evaluated by Doppler ultrasound at the popliteal level after saline injection via distal perfusion catheter. Clinical success was assessed when at least one of the following conditions was met: restoration of continuous peripheral limb oximetry value or presence of distal arterial pulse on Doppler ultrasound evaluation or resolution of early ischemic sign after connecting the catheter with ECMO. Twenty-six patients with early ischemia were successfully cannulated with a distal perfusion catheter (92.8%). Clinical success was achieved in 12/28 (42.8%) patients; 8/10 (80.0%) patients with survival duration exceeding 7 days and 4/18 (22.2%) patients with survival duration less than 7 days, respectively. A percutaneous distal perfusion catheter placement was a feasible tool with safety and efficacy in preventing lower limb ischemia for patients with prolonged common femoral arterial cannulation for ECMO.

  19. Superficial Temporal Artery Monitor

    Science.gov (United States)

    1986-03-01

    patient lying on such a " mattress " would eliminate the need for attachment of sensors and would be completely non-obstructive to medical personnel...are useful but not applicable to the cockpit environment because of their sensitivity to vibration , narrow beamwidth, and precise positioning

  20. Ipsilateral common iliac artery plus femoral artery clamping for inducing sciatic nerve ischemia/reperfusion injury in rats: a reliable and simple method

    Directory of Open Access Journals (Sweden)

    Barzegar-Fallah Anita

    2008-12-01

    Full Text Available Abstract The aim of this study was to develop a practical model of sciatic ischemia reperfusion (I/R injury producing serious neurologic deficits and being technically feasible compared with the current time consuming or ineffective models. Thirty rats were divided into 6 groups (n = 5. Animal were anesthetized by using ketamine (50 mg/kg and xylazine (4 mg/kg. Experimental groups included a sham-operated group and five I/R groups with different reperfusion time intervals (0 h, 3 h, 1 d, 4 d, 7 d. In I/R groups, the right common iliac artery and the right femoral artery were clamped for 3 hrs. Sham-operated animals underwent only laparotomy without induction of ischemia. Just before euthanasia, behavioral scores (based on gait, grasp, paw position, and pinch sensitivity were obtained and then sciatic nerves were removed for light-microscopy studies (for ischemic fiber degeneration (IFD and edema. Behavioral score deteriorated among the ischemic groups compared with the control group (p

  1. MRI after implantation of a novel femoral closure device following intra-arterial catheterisation: implications for subsequent contrast-enhanced MR angiography.

    Science.gov (United States)

    Mohrs, Oliver K; Petersen, Steffen E; Nowak, Bernd; Kauczor, Hans-Ulrich; Voigtlaender, Thomas

    2010-05-01

    To assess MRI safety aspects and artefacts of a novel femoral artery closure device during contrast-enhanced MR angiography in patients following intra-arterial catheterisation. Ten consecutive patients underwent MRI within 24 h of coronary angiography and placement of a femoral artery closure device. We used a T2-weighted gradient-echo MRI sequence to measure the device-related artefact size in comparison with a phantom image, phase-contrast flow measurement proximal to, at the level of and distal to the device to quantify potential differences in flow velocity and contrast-enhanced 3D gradient-echo MR angiography to differentiate potential femoral artery stenosis from device-related artefacts. The mean size of the oval-shaped artefact was 8.4 x 6.6 mm (+/-1.0 x 0.8 mm) and was almost identical to the maximum artefact size of the phantom measurement (8.3 x 5.7 mm). Device placement did not result in an increased peak velocity (proximal 69 +/- 23 cm/s, at the level of 64 +/- 11 cm/s and distal to the device 63 +/- 12 cm/s, p = 0.67). The mean artefact penetration into the vessel lumen was 0.5 +/- 0.5 mm (percentage vessel narrowing 7.0 +/- 6%; range 0-16%). The MR conditional StarClose femoral artery closure device was used safely within 24 h of deployment at 1.5 T. Despite clip-related artefacts MR angiography will allow for easy differentiation of clip-related artefacts from high-grade atherosclerotic stenosis.

  2. MRI after implantation of a novel femoral closure device following intra-arterial catheterisation: implications for subsequent contrast-enhanced MR angiography

    Energy Technology Data Exchange (ETDEWEB)

    Mohrs, Oliver K. [University of Heidelberg, Department of Diagnostic and Interventional Radiology, Heidelberg (Germany); Darmstadt Radiology, Department of Cardiovascular Imaging at Alice-Hospital, Darmstadt (Germany); Petersen, Steffen E. [The London Chest Hospital, William Harvey Research Institute, Centre Lead for Advanced Cardiovascular Imaging, London (United Kingdom); Nowak, Bernd; Voigtlaender, Thomas [Cardiovascular Center Bethanien (CCB), Frankfurt/Main (Germany); Kauczor, Hans-Ulrich [University of Heidelberg, Department of Diagnostic and Interventional Radiology, Heidelberg (Germany)

    2010-05-15

    To assess MRI safety aspects and artefacts of a novel femoral artery closure device during contrast-enhanced MR angiography in patients following intra-arterial catheterisation. Ten consecutive patients underwent MRI within 24 h of coronary angiography and placement of a femoral artery closure device. We used a T2-weighted gradient-echo MRI sequence to measure the device-related artefact size in comparison with a phantom image, phase-contrast flow measurement proximal to, at the level of and distal to the device to quantify potential differences in flow velocity and contrast-enhanced 3D gradient-echo MR angiography to differentiate potential femoral artery stenosis from device-related artefacts. The mean size of the oval-shaped artefact was 8.4 x 6.6 mm ({+-}1.0 x 0.8 mm) and was almost identical to the maximum artefact size of the phantom measurement (8.3 x 5.7 mm). Device placement did not result in an increased peak velocity (proximal 69 {+-} 23 cm/s, at the level of 64 {+-} 11 cm/s and distal to the device 63 {+-} 12 cm/s, p = 0.67). The mean artefact penetration into the vessel lumen was 0.5 {+-} 0.5 mm (percentage vessel narrowing 7.0 {+-} 6%; range 0-16%). The MR conditional StarClose femoral artery closure device was used safely within 24 h of deployment at 1.5 T. Despite clip-related artefacts MR angiography will allow for easy differentiation of clip-related artefacts from high-grade atherosclerotic stenosis. (orig.)

  3. Authentication of Radial Versus Femoral Arterial Pressure Waveform-Derived Cardiac Output With Transesophageal Echocardiography-Derived Cardiac Output Measurements in Patients Undergoing On-Pump Coronary Bypass Surgery.

    Science.gov (United States)

    Maddali, Madan Mohan; Waje, Niranjan Dilip; Sathiya, Panchatcharam Murthi

    2017-08-01

    The aim of this study was to ascertain if arterial waveform-derived cardiac output measurements from radial and femoral cannulation sites were reliable as compared with transesophageal echocardiography (TEE)-derived cardiac output (CO) values, and which of the CO measurements derived from radial and the femoral arterial pressure waveforms closely tracked simultaneously measured TEE-derived CO values. This study also aimed to ascertain if cardiopulmonary bypass (CPB) would impact the accuracy of arterial pressure-derived CO values from either of the 2 sites. A prospective observational study. Tertiary care cardiac center. Cardiac surgical patients undergoing on-pump primary coronary artery bypass surgery. Waveform-derived CO monitoring through radial and femoral artery cannulation using a FloTrac/Vigileo system. Twenty-seven consecutive cardiac surgical patients undergoing on-pump primary coronary artery bypass surgery were included in the study. Cardiac output was measured sequentially by the arterial pressure waveform analysis method from radial and femoral arterial sites and compared with simultaneously measured TEE-derived CO. Cardiac output data were obtained in triplicate at 6 predefined time intervals: before and after sternotomy, 5, 15, and 30 minutes after separation from CPB and prior to shifting the patient out of the operating room. The overall bias of the study was 0.11 and 0.27, the percentage error was 19.31 and 18.45, respectively, for radial and femoral arterial waveform-derived CO values as compared with TEE-derived CO measurements. The overall precision as compared with the TEE-derived CO values was 16.94 and 15.95 for the radial and femoral cannulation sites, respectively. The bias calculated by the Bland-Altman method suggested that CO measurements from the radial arterial site were in closer agreement with TEE-derived CO values at all time periods, and the relation was not affected by CPB. However, percentage error and precision calculations

  4. Model of osteonecrosis of the femoral head created by percutaneous transluminal medial femoral circumflex arterial ligation%经皮经腔旋股内动脉结扎制作股骨头坏死模型

    Institute of Scientific and Technical Information of China (English)

    杨秀军; 钱俨; 李巍; 卞国伟

    2011-01-01

    @@ 研究发现,髋关节牵引可导致旋股内、外动脉尤其股骨头供养血管闭塞与血运障碍[1-3],为了观察持续牵引、闭塞这些血管对股骨头血循环的影响尤其会否发生股骨头坏死(osteonecrosis of the femoral head,ONFH),笔者进行了经皮经腔犬旋股内动脉内结扎术(percutaneous transluminal medial femoral circumfflex arterial ligation,PTMFCAL)的研究,结果报告如下.

  5. Mycotic aneurysm of the femoral artery resulting from mismanagement of a pathological femur fracture due to chronic osteomyelitis: a case report

    Directory of Open Access Journals (Sweden)

    Mwaka Erisa Sabakaki

    2013-01-01

    Full Text Available Abstract Introduction Mycotic aneurysms are rarely listed among the possible complications of osteomyelitis of the long bones. To the best of our knowledge this is the first case of chronic osteomyelitis associated with a pathological fracture of the femur and a mycotic aneurysm of the femoral artery. Case presentation We present the case of a 13-year-old Ugandan boy who was referred to our hospital with chronic osteomyelitis associated with a pathological fracture of the right femur and a mycotic aneurysm of the femoral artery. He underwent a successful above-knee amputation and is currently undergoing rehabilitation. Conclusions Aneurysms associated with chronic osteomyelitis of the long bones are very rare. However, in Africa, where people often still believe in crude traditional remedies, they should be considered among the possible diagnoses especially where acute injuries of the limbs are massaged and manipulated.

  6. Assessment of intima-media complex in carotid, femoral and right subclavian arteries for early investigation of atherosclerosis in HIV-infected patients

    Directory of Open Access Journals (Sweden)

    Emmanuelle Tenorio Albuquerque Madruga Godoi

    2013-12-01

    Full Text Available Objective To compare automatic and manual measurements of intima-media complex (IMC in common carotid, common femoral and right subclavian arteries of HIV-infected patients in relation to a control group, taking into consideration the classical risk factors for atherosclerosis. Materials and Methods The study sample comprised 70 HIV-infected patients and 70 non-HIV-infected controls paired according sex and age. Automatic (gold standard and manual measurements of IMC were performed in the carotid arteries. Manual measurements were also performed in common femoral and right subclavian arteries. Bland-Altman graphs were utilized in the comparison and the adopted level significance was 5%. Results Intima-media complex alterations were not observed in any of the individuals as the mean automatic measurement in the right common carotid (RCC artery was considered as the gold standard. As the gold standard was compared with the manual measurements (mean, maximum and minimum, no clinically significant alteration was observed. As the gold standard was compared with other sites, the difference was statistically and clinically significant at the origin of right subclavian artery (RCC: 0.51 mm vs. 0.91 mm (p < 0.001. Conclusion HIV-infected individuals are not at higher risk for atherosclerosis than the control population.

  7. Randomized Controlled Trial on the Effect of Channa striatus Extract on Measurement of the Uterus, Pulsatility Index, Resistive Index of Uterine Artery and Superficial Skin Wound Artery in Post Lower Segment Caesarean Section Women.

    Directory of Open Access Journals (Sweden)

    Mohd Rizal Abu Bakar

    Full Text Available To compare the mean of anteroposterior (AP measurements of the uterus in longitudinal and oblique transverse planes, and the pulsatility index (PI and resistive index (RI of the uterine artery and superficial skin wound artery between patients taking Channa striatus and placebo.Channa striatus, also known as haruan, is a fresh water snakehead fish consumed in many parts of Southeast Asia. Channa striatus is also normally consumed by women postpartum to promote wound healing as well as to reduce post-operative pain.This study is a randomised, double blind, placebo-controlled study conducted in women after Lower Segment Caesarean Section (LSCS. Subjects were randomised to either a Channa striatus or a placebo group and were given a daily dosage of 500 mg of Channa striatus extract or 500 mg maltodextrin, respectively, for six weeks post LSCS. The anteroposterior measurements of the uterus in the longitudinal and oblique transverse planes, and the pulsatility index (PI and resistive index (RI of the uterine and superficial skin wound arteries were assessed using pelvic Gray-scale ultrasound and Doppler ultrasound at baseline (Day 3 and at two weeks, four weeks and six weeks post-operatively.Sixty-six subjects were randomised into the study with 33 in the Channa striatus group and 33 in the placebo group. No significant differences were detected in terms of the pulsatility index (PI and the resistive index (RI of the uterine and superficial skin wound arteries between the Channa striatus and placebo groups. However, in the Channa striatus group, the AP measurements of the uterus on the longitudinal and oblique transverse planes were significantly lower compared to the placebo group (p<0.05 and p<0.001, respectively.Daily intake of Channa striatus extract results in marked differences compared to placebo in terms of uterine involution and recovery in women post LSCS.www.isrctn.com 11960786.

  8. Randomized Controlled Trial on the Effect of Channa striatus Extract on Measurement of the Uterus, Pulsatility Index, Resistive Index of Uterine Artery and Superficial Skin Wound Artery in Post Lower Segment Caesarean Section Women

    Science.gov (United States)

    Abdul Karim, Ahmad Helmy; Nik Hussain, Nik Hazlina; Mohd Noor, Norhayati; Omar, Julia; Bin Bai @ Bae, Saringat; Wan Mahmood, Wan Haslindawani; Abdul Razak, Asrenee; Yunus, Rohaizan

    2015-01-01

    Aim To compare the mean of anteroposterior (AP) measurements of the uterus in longitudinal and oblique transverse planes, and the pulsatility index (PI) and resistive index (RI) of the uterine artery and superficial skin wound artery between patients taking Channa striatus and placebo. Background Channa striatus, also known as haruan, is a fresh water snakehead fish consumed in many parts of Southeast Asia. Channa striatus is also normally consumed by women postpartum to promote wound healing as well as to reduce post-operative pain. Methodology This study is a randomised, double blind, placebo-controlled study conducted in women after Lower Segment Caesarean Section (LSCS). Subjects were randomised to either a Channa striatus or a placebo group and were given a daily dosage of 500 mg of Channa striatus extract or 500 mg maltodextrin, respectively, for six weeks post LSCS. The anteroposterior measurements of the uterus in the longitudinal and oblique transverse planes, and the pulsatility index (PI) and resistive index (RI) of the uterine and superficial skin wound arteries were assessed using pelvic Gray-scale ultrasound and Doppler ultrasound at baseline (Day 3) and at two weeks, four weeks and six weeks post-operatively. Results Sixty-six subjects were randomised into the study with 33 in the Channa striatus group and 33 in the placebo group. No significant differences were detected in terms of the pulsatility index (PI) and the resistive index (RI) of the uterine and superficial skin wound arteries between the Channa striatus and placebo groups. However, in the Channa striatus group, the AP measurements of the uterus on the longitudinal and oblique transverse planes were significantly lower compared to the placebo group (p<0.05 and p<0.001, respectively). Conclusion Daily intake of Channa striatus extract results in marked differences compared to placebo in terms of uterine involution and recovery in women post LSCS. Trial Registration www.isrctn.com 11960786

  9. Diagnosis of abdominal mural aortic thrombus following discovery of common femoral artery and vein thrombosis by point-of-care ultrasound.

    Science.gov (United States)

    Shaukat, Nadia Maria; Taha, Farook; Vortsman, Eugene; Desai, Poonam; Kindschuh, Mark

    2015-12-01

    Acute limb ischemia (ALI) is a limb-threatening and life-threatening disease process. Mural aortic thrombosis (MAT) is a rare cause of ALI. While there is limited evidence on the use of bedside ultrasound for the detection of ALI or MAT, duplex ultrasound remains the standard in the diagnosis and ultimate medical decision-making in patients with acute and chronic limb ischemia. Point-of-care ultrasound may be used in the evaluation of patients with signs and symptoms of this disease entity. This is a case of a 79-year-old female with a complicated medical history, who presented with a pulseless right leg and abdominal tenderness. The patient quickly decompensated requiring intubation for airway protection. A post-intubation arterial blood gas (ABG) was unsuccessfully attempted in the right femoral artery, prompting an ultrasound-guided ABG. On B-mode ultrasound evaluation, echogenic material was visualized in the right common femoral artery without evidence of Doppler flow signal. Additionally, a partially obstructing echogenic material was also noted at the femoro-saphenous vein junction with only partial compressibility by compression sonography. A computed tomography angiography of the aorta was performed indicating extensive infrarenal aortic thrombosis. The patient expired despite the relatively prompt diagnosis, highlighting the importance of early identification of acute arterial occlusion.

  10. Simultaneous mapping of temporally-resolved blood flow velocity and oxygenation in femoral artery and vein during reactive hyperemia

    Directory of Open Access Journals (Sweden)

    Langham Michael C

    2011-10-01

    Full Text Available Abstract Background Post-occlusive hyperemia is often used as a paradigm to evaluate vascular reactivity, for example by measuring post-ischemic flow-mediated dilation, arterial blood flow or temporally resolved venous blood oxygenation (HbO2. Here we demonstrate the feasibility of a simultaneous measurement of blood flow and HbO2 in the femoral circulation as part of a single procedure. Methods A multi-echo GRE pulse sequence was designed and implemented to collect velocity-encoded projections in addition to full-image echoes for field mapping as a means to quantify intravascular magnetic susceptibility. The method's feasibility was evaluated at 3T in a small pilot study involving two groups of healthy subjects (mean ages 26 ± 1.6 and 59 ± 7.3 years, N = 7 and 5, respectively in terms of six parameters characterizing the time-course of reactive hyperemia and their sensitivity to differentiate age effects. The reproducibility was assessed on two of the seven young healthy subjects with three repeated measurements. Results The physiological parameters agree with those obtained with current methods that quantify either velocity or HbO2 alone. Of the six measures of vascular reactivity, one from each group was significantly different in the two subject groups (p Conclusion The proposed method is able quantify multiple parameters that may lead to more detailed assessment of peripheral vascular reactivity in a single cuff paradigm rather than in separate procedures as required previously, thereby improving measurement efficiency and patient comfort.

  11. Optimization of Ecg Gating in Quantitative Femoral Angiography

    Energy Technology Data Exchange (ETDEWEB)

    Nilsson, S.; Berglund, I.; Erikson, U. [Univ. Hospital, Uppsala (Sweden). Dept. of Oncology, Radiology and Clinical Immunology; Johansson, J.; Walldius, G. [Karolinska Hospital, Stockholm (Sweden). King Gustav V Research Inst.

    2003-09-01

    Purpose: To determine which phase of the heart cycle would yield the highest reproducibility in measuring atherosclerosis-related variables such as arterial lumen volume and edge roughness. Material and Methods: 35 patients with hypercholesterolemia underwent select ive femoral angiography, repeated four times at 10-min intervals. The angiographies were performed with Ecg-gated exposures. In angiographies 1 and 2 the delay from R-wave maximum to each exposure was 0.1 s, in angiographies 3 and 4 the delay was 0.1, 0.3, 0.5 or 0.7 s or the exposures were performed 1/s without Ecg gating. Arterial lumen volume and edge roughness were measured in a 20-cm segment of the superficial femoral artery using a computer-based densitometric method. Measurement reproducibility was determined by comparing angiographies 1-2 and angiographies 3-4. Results: When measuring arterial lumen volume and edge roughness of a 20-cm segment of the femoral artery, reproducibility was not dependent on Ecg gating. In measuring single arterial diameters and cross-sectional areas, the reproducibility was better when exposures were made 0.1 s after the R-wave maximum than when using other settings of the Ecg gating device or without Ecg gating. Conclusion: The influence of pulsatile flow upon quantitative measurement in femoral angiograms seems to be the smallest possible in early systole, as can be demonstrated when measuring single diameters and cross-sectional areas. In variables based on integration over longer segments, measurement reproducibility seems to be independent of phase.

  12. Thoracic Stent Graft Implantation for Aortic Coarctation with Patent Ductus Arteriosus via Retroperitoneal Iliac Approach in the Presence of Small Sized Femoral Artery

    Directory of Open Access Journals (Sweden)

    Ozge Korkmaz

    2016-01-01

    Full Text Available Endovascular stent graft implantation is a favorable method for complex aortic coarctation accompanied by patent ductus arteriosus. Herein, an 18-year-old woman with complex aortic coarctation and patent ductus arteriosus was successfully treated by endovascular thoracic stent graft via retroperitoneal approach. The reason for retroperitoneal iliac approach was small sized common femoral arteries which were not suitable for stent graft passage. This case is the first aortic coarctation plus patent ductus arteriosus case described in the literature which is treated by endovascular thoracic stent graft via retroperitoneal approach.

  13. Anatomic study of branches-chain base on the superficial peroneal artery%腓浅动脉皮支链的应用解剖

    Institute of Scientific and Technical Information of China (English)

    秦向征; 刘鹏; 许东元; 刘环宇; 金昱; 延光海; 方今女; 丁自海

    2015-01-01

    Objective To definite the specific area and morphology of the branches-chain base on the superficial peroneal artery,provide the Anatomical information for Taking the branches-chain flap.Methods From October,2012 to September,2013,a total of 15 fresh adult cadaveric lower limb were used in the research:which were 3 females and 12 males.There was no history of trauma and surgery.Thirteen specimens were perfused with red latex for microanatomy to observe linking form of the the cutaneous perforators,measuring the outer diameter of perforators at the deep fascia.2 specimens were perfused with self-curing denture acrylic to be vascular cast mold.Results A total of 61 cutaneous branches issued fom the chain of the superficial peroneal nerve nutrient vessels,each side was (4.38 ± 0.77) cutaneous branches,which were the diameter of wearing the deep fascia was (0.57 ± 0.14) mm; Fibula length was (347.76 ± 17.78) mm,The number of cutaneous branches participating the branches-chain was 28,averaged on each side of (2.15 ± 0.38).The diameter was (0.45 ± 0.13) mm,and the area of cutaneous branches-chain of the superficial peroneal artery was (45.95 ± 13.08)% to (76.91 ± 8.71)%.Conclusion Taking the dislocation or free cutaneous flap is safe with branches-chain base on the superficial peroneal artery as the axis in the medium and lower segment of anterolateral of crus.%目的 明确腓浅动脉皮支链形成的区域和形态,为临床切取小腿前外侧皮支链皮瓣提供解剖学基础. 方法 2012年10月-2013年9月,解剖新鲜成年尸体标本下肢15侧,女性3侧,男性12侧,皮肤观察无外伤及手术史.13侧下肢经股动脉灌注红色乳胶,手术显微镜下精细解剖,显示各皮支来源、链状吻合部位和形态,于穿深筋膜处测量各皮支的外径.2侧下肢制做动脉铸型标本. 结果 腓浅动脉皮支共61支,每侧(4.38±0.77)支,各皮支穿过深筋膜处的直径为(0.57±0.14)mm;参与构成腓浅

  14. Fundamental Basis of Scalp Layering Techniques to Protect Against Wound Infection: A Comparative Study Between Conventional and In-to-Out Dissection of the Superficial Temporal Artery.

    Science.gov (United States)

    Chung, Yeongu; Lee, Sung Ho; Choi, Seok Keun

    2017-01-01

    Superficial temporal artery (STA) to middle cerebral artery (MCA) bypass is associated with several surgical problems. Despite the vascular patency and hemodynamic changes after the anastomosis, wound problems can be a major surgical complication. In a review of 41 surgical cases of STA-MCA bypass for moyamoya disease or cerebral occlusive vascular disease, we compared the conventional (out-to-in) dissection method for STA (n = 23) with the in-to-out (ITO) dissection method (n = 18) and evaluated the surgical results with respect to wound problems. The incidence of skin maceration was significantly higher in the conventional dissection group than the ITO dissection group (34.8% vs. 5.5%; P dissection group (39.1%) than the ITO group (22.2%). These data suggest that the simple layering technique of the ITO dissection method can protect against contamination from bacteria and reduce postoperative surgical wound problems. Sealing of the galea aponeurotica (first protective barrier), including fibrous septa and loose areolar tissues, including the periosteal layer (second protective barrier), is an important factor to decrease the rate of scalp wound infection. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Comparison of the Efficiencies of Buffers Containing Ankaferd and Chitosan on Hemostasis in an Experimental Rat Model with Femoral Artery Bleeding

    Directory of Open Access Journals (Sweden)

    Kemal Aydın

    2016-03-01

    Full Text Available Objective: In the first assessment of trauma patients with major vascular injuries, we need effective and rapid-acting homeostatic materials. In this study we compare the efficiencies of Ankaferd Blood Stopper® and a chitosan linear polymer (Celox® in an experimental rat model with femoral artery bleeding. Materials and Methods: Thirty male Wistar albino rats weighing 200- 250 g were divided into 3 groups: control, Ankaferd, and chitosan. The femoral artery and vein were visualized and bleeding was started by an incision. The bleeding time was recorded and categorized as ‘bleeding stopped at the second minute’, ‘bleeding stopped at the fourth minute’, and ‘unsuccessful’ if bleeding continued after the fourth minute. Results: In the control group, 60% of the bleeding did not stop. In the first 4 min in the Ankaferd group, the bleeding stopped in all rats; only in 1 of the rats in the chitosan group did the bleeding not stop. In stopping the bleeding in the first 4 min, Ankaferd was similar to chitosan but better than the control group; the chitosan group was similar to the control, but the p-value was close to significance. Conclusion: For major arterial bleeding, the main treatment is surgical bleeding control, but outside of the hospital we can use buffers containing Ankaferd and chitosan on the bleeding region. The results of this study should be supported with larger studies. Furthermore, in our study, healthy rats were used. New studies are needed to evaluate the results of hypovolemic and hypotensive cases with major artery bleeding

  16. Quadruple-component superficial circumflex iliac artery perforator (SCIP) flap: A chimeric SCIP flap for complex ankle reconstruction of an exposed artificial joint after total ankle arthroplasty.

    Science.gov (United States)

    Yamamoto, Takumi; Saito, Takafumi; Ishiura, Ryohei; Iida, Takuya

    2016-09-01

    Total ankle arthroplasty (TAA) is becoming popular in patients with rheumatoid arthritis (RA)-associated ankle joint degeneration. However, ankle wound complications can occur after TAA, which sometimes requires challenging reconstruction due to anatomical complexity of the ankle. Superficial circumflex iliac artery (SCIA) perforator (SCIP) flap has been reported to be useful for various reconstructions, but no case has been reported regarding a chimeric SCIP flap for complex ankle reconstruction. We report a case of complex ankle defect successfully reconstructed with a free quadruple-component chimeric SCIP flap. A 73-year-old female patient with RA underwent TAA, and suffered from an extensive ankle soft tissue defect (13 × 5 cm) with exposure of the implanted artificial joint and the extensor tendons. A chimeric SCIP flap was raised based on the deep branch and the superficial branch of the SCIA, which included chimeric portions of the sartorius muscle, the deep fascia, the inguinal lymph node (ILN), and the skin/fat. The flap was transferred to the recipient ankle. The sartorius muscle was used to cover the artificial joint, the deep fascia to reconstruct the extensor retinaculum, the ILN to prevent postoperative lymphedema, and the adiposal tissue to put around the extensor tendons for prevention of postoperative adhesion. Postoperatively, the patient could walk by herself without persistent leg edema or bowstringing of the extensor tendons, and was satisfied with the concealable donor scar. Although further studies are required to confirm efficacy, multicomponent chimeric SCIP has a potential to be a useful option for complex defects of the ankle.

  17. The effect of the superficial temporal to middle cerebral artery bypass based on the data of motor activation single photon emission computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Kawaguchi, Shoichiro; Uranishi, Ryunosuke; Morimoto, Tetsuya; Sakaki, Toshisuke; Imai, Teruhiko; Ohishi, Hajime [Nara Medical Univ., Kashihara (Japan)

    1999-07-01

    We evaluated and analyzed the effect of the superficial temporal to middle cerebral artery (STA-MCA) bypass for the pure motor function in the ischemic cerebrovascular diseases (CVDs) using the motor activation single photon emission computed tomography (SPECT). Motor activation SPECT was performed on the 25 cases with ischemic CVD treated with STA-MCA bypass. Motor activation SPECT studies using the finger opposition task on the affected side were performed before surgery, at 1 month, and at 3 months after the bypass. The result of the motor activation SPECT was expressed as negative and positive by the visual inspection. During the follow-up period (mean; 2.2 years), there has been no recurrent or worsening clinical symptom. Before bypass, 10 cases were positive in the motor activation SPECT. The other 15 cases were negative. At one month after bypass, 14 cases were positive in the motor activation SPECT. At three months after bypass, 23 cases were positive in the motor activation SPECT. Twenty-two cases showed the improvement of the resting CBF. STA-MCA bypass is useful for pure motor function in the ischemic CVDs based on the motor activation SPECT coupling with their clinical symptoms. (author)

  18. Intima-Media Thickness in the Carotid and Femoral Arteries for Detection of Arteriosclerosis in Human Immunodeficiency Virus-Positive Individuals

    Science.gov (United States)

    Godoi, Emmanuelle Tenório Albuquerque Madruga; Brandt, Carlos Teixeira; Lacerda, Heloisa Ramos; Godoi, Jocelene Tenório Albuquerque Madruga; de Oliveira, Dinaldo Cavalcanti; Costa, Gabriela Farias Araujo Sousa; dos Santos Junior, Gerson Gomes; Leite, Kaliene Maria Estevão; Godoi, Juannicelle Tenório Albuquerque Madruga; de Vasconcelos, Adriana Ferraz

    2017-01-01

    Background The prevalence of atherosclerosis is higher in HIV-positive people, who also experience it earlier than the general population. Objectives To assess and compare the prevalence of atherosclerosis evaluated by the intima-media thickness of carotid and femoral arteries, and by the ankle-brachial pressure index (ABPI) in HIV patients treated or not treated with protease inhibitors (PIs) and controls. Methods Eighty HIV+ subjects (40 using PIs and 40 not using PIs) and 65 controls were included in the study. Atherosclerosis was diagnosed by (carotid and femoral) ITM measurement and ABPI. Classical risk factors for atherosclerosis and HIV were compared between the groups by statistical tests. A p ≤ 0.05 was considered significant. Results An IMT > P75 or the presence of plaque was higher in the HIV+ than in the control group (37.5% vs 19%, p = 0.04). Comparative analysis showed a significant difference (p=0.014) in carotid IMT between HIV+ with PIs (0.71 ± 0.28 mm), without PIs 0.63 ± 0.11 mm and, and controls (0.59 ± 0.11 mm). There was no significant difference in femoral IMT between the groups or in ABPI between HIV+ subjects and controls. However, a significant difference (p=0.015) was found between HIV+ patients not treated with PIs (1.17 [1.08 - 1.23]), and controls 1.08 [1.07 - 1.17]). Conclusion In HIV patients, atherosclerosis is more prevalent and seems to occur earlier with particular characteristics compared with HIV-negative subjects. PMID:28146208

  19. Suitability of a 7-F ExoSeal Vascular Closure Device for Femoral Artery Punctures Made by 8-F or 9-F Introducer Sheaths.

    Science.gov (United States)

    Goto, Shunsaku; Ohshima, Tomotaka; Ishikawa, Kojiro; Yamamoto, Taiki; Nishizawa, Toshihisa; Shimato, Shinji; Kato, Kyozo

    2017-08-01

    To establish the safety and efficacy of the 7-F ExoSeal device for the closure of femoral puncture sites made by 8-F or 9-F introducer sheaths. Between January 2013 and December 2016, 332 patients (mean age 68.4±12.1 years; 195 men) underwent neurointerventional procedures via percutaneous puncture of the common femoral artery and an 8-F (n=272, 81.9%) or 9-F (n=60, 18.1%) introducer. The access sites were sealed with a 7-F ExoSeal in all cases. Procedure success and closure-related complication rates were evaluated, and risk factors for complications were analyzed by comparing patient characteristics between those who did and did not experience complications. Procedure success rates were 99.3% in the 8-F group and 100% in the 9-F group. The overall complication rate was 6.3% (n=17; all in the 8-F group), of which 13 (4.8%) were minor sequelae, including access-site hematoma (n=8), oozing (n=3), pseudoaneurysm (n=1), and retroperitoneal bleeding (n=1). Among the 4 (1.5%) major complications were 3 instances of bleeding requiring a blood transfusion and 1 surgical vascular repair. No complications were observed in the 9-F group. Patients who experienced complications had significantly longer activated clotting times (262±46 vs 218±55 seconds; pF ExoSeal vascular closure device is safe and effective for the closure of femoral puncture sites made by 8-F or 9-F introducer sheaths.

  20. Association of Serum HMGB2 Levels With In-Stent Restenosis: HMGB2 Promotes Neointimal Hyperplasia in Mice With Femoral Artery Injury and Proliferation and Migration of VSMCs.

    Science.gov (United States)

    He, Yu Hu; Wang, Xiao Qun; Zhang, Jian; Liu, Zhu Hui; Pan, Wen Qi; Shen, Ying; Zhu, Zheng Bin; Wang, Ling Jie; Yan, Xiao Xiang; Yang, Ke; Zhang, Rui Yan; Shen, Wei Feng; Ding, Feng Hua; Lu, Lin

    2017-04-01

    In a previous study, we established diabetic and nondiabetic minipig models with coronary artery in-stent restenosis (ISR). Mass spectrometry showed that high-mobility group box (HMGB) 2 level was higher in ISR than in non-ISR tissue from diabetic minipigs. We here investigated whether serum HMGB2 levels were related to ISR in coronary artery disease patients. The effect of HMGB2 was evaluated in mice with femoral artery wire injury and in human aortic smooth muscle cells. From 2513 patients undergoing coronary artery intervention and follow-up angiography at ≈1 year, 262 patients were diagnosed with ISR, and 298 patients with no ISR were randomly included as controls. Serum HMGB2 levels were significantly higher in patients with ISR than in those without ISR and were associated with ISR severity. Multivariable logistic regression analysis showed that HMGB2 level was independently associated with ISR. In experiments, HMGB2 expression was increased in vascular tissue after injury. Perivascular HMGB2 administration promoted injury-induced neointimal hyperplasia in C57Bl/6 mice compared with in the control, whereas such pathophysiological features were attenuated in Hmgb2(-/-) mice. Mechanistically, HMGB2 enhanced neointimal hyperplasia in mice and proliferation and migration in human aortic smooth muscle cells by inducing reactive oxygen species through increased p47phox phosphorylation. Knocking down p47phox, however, inhibited HMGB2-induced effects in human aortic smooth muscle cells. Finally, HMGB2-induced effects were significantly declined in receptor of advanced glycation end products knockdown or deficient cells, but not in Toll-like receptor 4 knockdown or deficient cells. Serum HMGB2 levels were associated with ISR in patients. HMGB2 promoted neointimal hyperplasia in mice with arterial wire injury through reactive oxygen species activation. © 2017 American Heart Association, Inc.

  1. Emerging Stent and Balloon Technologies in the Femoropopliteal Arteries

    Directory of Open Access Journals (Sweden)

    Georgios Pastromas

    2014-01-01

    Full Text Available Endovascular procedures for the management of the superficial femoral (SFA and popliteal artery disease are increasingly common. Over the past decade, several stent technologies have been established which may offer new options for improved clinical outcomes. This paper reviews the current evidence for SFA and popliteal artery angioplasty and stenting, with a focus on randomized trials and registries of nitinol self-expanding stents, drug-eluting stents, dug-coated balloons, and covered stent-grafts. We also highlight the limitations of the currently available data and the future routes in peripheral arterial disease (PAD stent and balloon technology.

  2. Superficial and deep sternal wound infection after more than 9000 coronary artery bypass graft (CABG: incidence, risk factors and mortality

    Directory of Open Access Journals (Sweden)

    Abbasi Kyomars

    2007-09-01

    Full Text Available Abstract Background Sternal wound infection (SWI is an uncommon but potentially life-threatening complication of cardiac surgery. Predisposing factors for SWI are multiple with varied frequencies in different studies. The purpose of this study was to assess the incidence, risk factors, and mortality of SWI after coronary artery bypass grafting (CABG at Tehran Heart Center. Methods This study prospectively evaluated multiple risk factors for SWI in 9201 patients who underwent CABG at Tehran Heart Center between January 2002 and February 2006. Cases of SWI were confirmed based on the criteria of the Centers for Disease Control and Prevention. Deep SWI (bone and mediastinitis was categorized according to the Oakley classification. Results In the study period, 9201 CABGs were performed with a total SWI rate of 0.47 percent (44 cases and deep SWI of 0.22 percent (21 cases. Perioperative (in-hospital mortality was 9.1% for total SWI and about 14% for deep SWI versus 1.1% for non-SWI CABG patients. Female gender, preoperative hypertension, high functional class, diabetes mellitus, obesity, prolonged intubation time (more than 48 h, and re-exploration for bleeding were significant risk factors for developing SWI (p = 0.05 in univariate analysis. In multivariate analysis, hypertension (OR = 10.7, re-exploration (OR = 13.4, and female gender (OR = 2.7 were identified as significant predictors of SWI (p Conclusion Rarely reported previously, the two risk factors of hypertension and the female gender were significant risk factors in our study. Conversely, some other risk factors such as cigarette smoking and age mentioned as significant in other reports were not significant in our study. Further studies are needed for better documentation.

  3. Plasma levels of the arterial wall protein fibulin-1 are associated with carotid-femoral pulse wave velocity

    DEFF Research Database (Denmark)

    Laugesen, Esben; Høyem, Pernille; Christiansen, Jens Sandahl;

    2013-01-01

    -associated extracellular matrix protein, fibulin-1, was recently found in higher concentrations in the arterial wall and in plasma in patients with long duration type 2 diabetes. Furthermore, plasma fibulin-1 independently predicted total mortality and was associated with pulse pressure, an indirect measure of arterial...

  4. Dissociation between the time courses of femoral artery blood flow and pulmonary VO2 during repeated bouts of heavy knee extension exercise in humans.

    Science.gov (United States)

    Fukuba, Yoshiyuki; Ohe, Yukie; Miura, Akira; Kitano, Asami; Endo, Masako; Sato, Hironori; Miyachi, Motohiko; Koga, Shunsaku; Fukuda, Osamu

    2004-05-01

    It has frequently been demonstrated that prior heavy cycling exercise facilitates pulmonary O(2) kinetics at the onset of subsequent heavy exercise. This might be due to improved muscle perfusion via acidosis-induced vasodilating effects. However, it is difficult to measure the blood flow (BF) to the working muscles (via the femoral artery) during cycling exercise. We therefore selected supine knee extension (KE) exercise as an alternative, and investigated whether the faster O(2) kinetics in the 2nd bout was matched by proportionally faster BF kinetics to the exercising muscle. Nine healthy subjects (aged 21-44 years) volunteered to participate in this study. The protocol consisted of two consecutive 6-min KE exercise bouts in a supine position (work rate: 70-75% of peak power) separated by a 6-min baseline rest (EX1 to EX2). During the protocol, a pulsed Doppler ultrasound technique was utilized to continuously measure the BF in the right femoral artery. The protocol was repeated at least 6 times to characterize the precise kinetics. In agreement with previous studies using cycling exercise, the O(2) kinetics in the 2nd bout were facilitated compared with that in the 1st bout [mean +/-s.d. of the 'effective' time constant (tau): EX1, 68.6 +/- 15.9, versus EX2, 58.0 +/- 14.4 s. Phase II-tau: EX1, 48.7 +/- 9.0, versus EX2, 41.2 +/- 13.3 s. Empirical index of the slow component (Delta O(2(6-3))): EX1, 78 +/- 44, versus EX2, 57 +/- 36 ml min(-1) (P 0.05)]. It was concluded that the faster pulmonary O(2) kinetics during heavy KE exercise following prior heavy exercise was not associated with a similar modulation in the BF to the working muscles.

  5. Ultrasound-guided Thrombin Injection: An Alternative Treatment for Femoral Artery Pseudoaneurysm with Better Efficiency and Safety

    Institute of Scientific and Technical Information of China (English)

    Qinghai YAO; Hongliang CONG; Shangqin WU; Shan SUN; Qike DONG; Dongmei CHEN; Peng LI

    2008-01-01

    The aim of this study was to evaluate the efficiency and safety of ultrasound-guided thrombin injection on femoral pseudoaneurysm (FPA) as compared to ultrasound-guided local oppression. Eleven cases of FPA were enrolled and 7 cases received ultrasound-guide thrombin injection (injection group), and the remaining 4 cases were treated with local oppression (oppression group). Efficiency and safety were analyzed by ultrasound and subsequent follow-up. The results showed that 1 case relapsed in oppression group while no relapse occurred in thrombin injection group. Ultrasound-guided thrombin injection is better for treatment of FPA in terms of effectiveness and safety.

  6. Is There an Association Between Carotid-Femoral Pulse Wave Velocity and Coronary Heart Disease in Patients with Coronary Artery Disease: A Pilot Study.

    Science.gov (United States)

    Katsiki, Niki; Kollari, Erietta; Dardas, Sotirios; Dardas, Petros; Haidich, Anna-Bettina; Athyros, Vasilios G; Karagiannis, Asterios

    2016-01-01

    Arterial stiffness has been shown to predict cardiovascular morbidity and mortality. Carotid-femoral pulse wave velocity (cfPWV) is regarded the gold standard marker of arterial stiffness. In previous studies, cfPWV was associated with the presence of coronary heart disease (CHD). However, with regard to CHD severity as assessed by the Syntax Score, only brachial-ankle PWV was reported to correlate with Syntax Score; no data exist for cfPWV. In this pilot study, we evaluated the possible associations between cfPWV, CHD and Syntax Score in 62 consecutive pa-tients (49 males; mean age: 64±12years) with chest pain undergoing scheduled coronary angiography. cfPWV was signifi-cantly higher in CHD patients than in non-CHD individuals (10 vs. 8.4 m/s; p = 0.003). No significant association was found between cfPWV and CHD severity as assessed by Syntax Score. A cut-off point of 12.3 m/s was considered as diagnostic for abnormally increased cfPWV (specificity: 97%; sensitivity: 12%; positive likelihood ratio: 3.558). Further research is needed to establish the relationship between cfPWV and Syntax Score.

  7. The effect of intermittent intraabdominal pressure elevations and low cardiac output on the femoral to carotid arterial blood pressure difference in piglets.

    Science.gov (United States)

    Aksakal, Devrim; Hückstädt, Thomas; Richter, Steffen; Klitscher, Daniela; Wowra, Tobias; Schier, Felix; Wessel, Lucas M; Kubiak, Rainer

    2016-11-01

    Our previous work in a laparoscopic setting in piglets revealed that the systolic femoral artery pressure was approximately 5 % higher than its carotid counterpart, whereas the mean and diastolic values showed no significant difference. This remained idem when the intraabdominal pressure (IAP) was gradually increased. In this study, we aimed to investigate the effect of (1) intermittent IAP elevations and (2) a low cardiac output (CO) on the blood pressure (BP) difference cranially (carotid artery) and caudally (femoral artery) of a capnoperitoneum (ΔP = P a fem-P a carot). A total of twenty-two piglets (mean body weight 11.0 kg; range 8.9-13.3 kg) were studied. Of these, 14 underwent intermittent IAP elevations at 8 and 16 mmHg, and ΔP was measured. In another 8 piglets, a model of reduced CO was created by introducing an air embolism (2 ml/kg over 30 s) in the inferior caval vein (VCI) at 12 mmHg IAP to further assess the influence of this variable on ΔP. Systolic ΔP remained at a mean of 5.6 mmHg and was not significantly affected by insufflation or exsufflation up to an IAP of 16 mmHg. Diastolic and mean values showed no differences between P a carot and P a fem. P a fem, systol remained higher than its carotid counterpart as long as the cardiac index (CI) was above 1.5 l/min/m(2), but fell significantly below P a carot, systol at a low CI. There was no CO-dependent effect on diastolic and mean ΔP. Repeated IAP elevations do not significantly influence ΔP. Intermittent IAP elevations do not significantly influence ΔP. Despite of a CO-dependent inversion of systolic ΔP, mean BP measurements at the leg during laparoscopy remain representative even at low CO values.

  8. Clinical efficient of encircling constriction of superficial femoral vein in the treatment of primary deep venous insufficiency on a report of 187 cases%下肢股浅静脉瓣膜环缩术治疗原发性深静脉瓣膜功能不全187例效果分析

    Institute of Scientific and Technical Information of China (English)

    谷军保; 鲍学斌; 马钊

    2012-01-01

    Objective To evaluate the therapeutic effect of encircling constriction of superficial femoral vein in the treatment of primary deep venous insuficiency(PDVI).Methods From Jan.2004 to Jun.2011,187 patients( 196 lower extremities)with primary deep venous insufficiency were treated with encircling constriction of venous wall at the first pair of superficial femoral venous valve pulse superficial varicose stripping.Results The 183 limbs in 176 patients were followed-up from 7 months to 8 years,with a mean period for 63.5 months.Ninety-four point one percent of the patients were followed up (176/187).Clinical symptomatic improvement achieved in 87.4% ( 160/183 ) of the lower extremities.There was 2.2% ( 4/183 ) of recurrence of the varicose vein,9.3% ( 17/183 ) of light edema,8% ( 2/25 ) of recurrence of ulcer.Conclusion Encircling constriction of superficial femoral vein is an effective method in the treatment of primary deep venous valve insufficiency.%目的 评估应用股浅静脉瓣膜环缩术治疗原发性下肢深静脉瓣膜功能不全的效果.方法 回顾性总结2004年1月至2011年6月,我院187例(196条肢体)原发性下肢深静脉瓣膜功能不全患者采用股浅静脉第一对瓣膜环缩加曲张浅静脉剥脱术治疗的临床资料.结果 176例(183条肢体)术后随访7个月~8年,中位随访时间63.5个月,随访率94.1% (176/187);临床症状明显缓解,疗效良好160条,占随访肢体87.4%( 160/183);术后出现浅静脉曲张复发4条,占2.2% (4/183);轻度肿胀17条,占9.3% (17/183);溃疡复发2条,占8% (2/25).结论 股浅静脉瓣膜环缩术是治疗原发性下肢深静脉瓣膜功能不全的有效方法.

  9. Serotonin-induced blood flow changes in the rat hindlegs after unilateral ligation of the femoral artery. Inhibition by the S2 receptor antagonist ketanserin.

    Science.gov (United States)

    Verheyen, A; Vlaminckx, E; Lauwers, F; Van Den Broeck, C; Wouters, L

    1984-08-01

    Collateral arteries can clearly be visualized in corrosion cast material after ligation of the femoral artery in rats. To characterize the influence of serotonin on the blood circulation under the experimental condition of unilateral ligation, we performed intermuscular thermoflow measurements. The data showed that intraperitoneal serotonin (8.7 and 20 mg.kg-1) injection markedly reduced the muscle temperature in both hindlegs. However, the effect was significantly more pronounced on the ligated side, where the blood was supplied through a collateral circulation, than on the non-ligated side with its normal arterial vasculature. Almost identical changes were obtained in rats with an early as well as in animals with a more advanced stage of collateral development (challenge with 8.7 mg.kg-1 serotonin). Evans blue dye experiments and angiographic data further revealed that, after challenge with 20 mg.kg-1 serotonin, the severe temperature decrease at the ligated side probably reflected a nearly complete blockage of blood supply. Pretreatment with the S2 receptor antagonist ketanserin (2.5 mg.kg-1) resulted in a significant reduction in the extent and duration of the serotonin-induced temperature decrease as revealed by the temperature measurements; such a treatment inhibited also the blockage in blood flow as seen with the other techniques. This study shows that serotonin, through its vasoconstrictive properties, can restrict the blood flow to the lower extremities of the rat, particularly when the blood is supplied through collateral circulation. This probably results in moderate to severe skeletal muscle ischaemia. It also suggests that the vasoconstriction is not only important in the inhibition of collateral blood flow in recently established collaterals but also in collateral vessels in a more advanced stage of development. The in vivo vasoconstriction and subsequent reduction of the blood supply caused by serotonin can be effectively counteracted by

  10. Clinical observation of femoral artery pressure perfusion of Shuxuetong injection on the treatment of phase Ⅱlower limb arteriosclerosis obliterans%疏血通注射液股动脉加压灌注治疗Ⅱ期下肢动脉硬化闭塞症60例临床观察

    Institute of Scientific and Technical Information of China (English)

    姜淑凤; 艾发元; 苗志勃; 王丽娟; 贾岩

    2012-01-01

    .05). Hemorheology, fibrin quantitative, blood flow beam width and flow spectrum peak after treatment were significantly improved as compared with those before treatment in two groups ( P < 0.05, P < 0.01). The improvement of whole blood viscosity (low shear) and plasma viscosity, blood flow beam width of superficial femoral artery, dorsalis pedis artery and flow spectrum peak of the posterior tibial artery and the superficial femoral artery, popliteal artery and anterior tibial artery in treatment group were superior to those in control group (P< 0.05). There was no obvious adverse reaction in two groups. Conclusion Femoral artery pressure perfusion ofShuxuetong injection for the treatment of phase E lower limb arteriosclerosis obliterans was safe, effective and worthy of clinical application.

  11. Riscos e consequências do uso da técnica transportal na reconstrução do ligamento cruzado anterior: relação entre o túnel femoral, a artéria genicular lateral superior e o epicôndilo lateral do côndilo femoral Risks and consequences of using the transportal technique in reconstructing the anterior cruciate ligament: relationships between the femoral tunnel, lateral superior genicular artery and lateral epicondyle of the femoral condyle

    Directory of Open Access Journals (Sweden)

    Diego Costa Astur

    2012-10-01

    Full Text Available OBJETIVO: Definir zona de segurança para evitar possíveis complicações vasculares e ligamentares durante a reconstrução do ligamento cruzado anterior. MÉTODOS: Reconstrução artroscópica com uso de técnica transportal e transtibial em joelhos de cadáver foi realizada seguida de dissecção e mensuração da distância entre o túnel femoral e a inserção proximal do ligamento colateral lateral e o túnel femoral e a artéria genicular lateral superior. RESULTADOS: A mensuração das distâncias analisadas mostra uma aproximação maior do principal ramo da artéria genicular lateral superior e da inserção proximal do ligamento colateral lateral com o túnel femoral, realizado com a técnica transportal. CONCLUSÃO: Percebemos que o uso da técnica transportal para reconstrução artroscópica do LCA apresenta maior probabilidade de lesão da artéria genicular lateral e da inserção do ligamento colateral lateral, favorecendo complicações pós-cirúrgicas como instabilidade do joelho, osteonecrose do côndilo femoral lateral e ligamentização do enxerto.OBJECTIVE: Define a security zone to avoid possibles vascular and ligamentar complications during anterior cruciate ligament reconstruction. METHODS: Arthroscopic reconstruction using the transtibial and transportal technique in cadaver knees was performed followed by dissection and measurement of the distance between the femoral tunnel and the proximal attachment of the lateral collateral ligament and the femoral tunnel and the lateral superior genicular artery. RESULTS: The measure of the analysed distances show us an aproximation between the major branch of the lateral superior genicular artery and the femoral insertion of the colateral lateral ligament and the femoral tunnel during the transportal technique. CONCLUSION: We realize that the use of technical ship it to arthroscopic ACL reconstruction has a higher probability of injury to the lateral geniculate artery and

  12. Breast reconstruction with superficial inferior epigastric artery flap%腹壁浅动脉蒂游离腹壁皮瓣乳房再造术的初步临床应用

    Institute of Scientific and Technical Information of China (English)

    穆大力; 栾杰; 穆兰花; 严义坪

    2010-01-01

    Objective To present a method for breast reconstruction with the superficial inferior epigastric artery (S1EA) flap and to summarize the operative experiences. Methods The diameter and distribution were evaluated with multipledetector-row computed tomography (MDCT) angiography and doppler perfusion flowmeter. Bipedicle superficial inferior epigastric artery flap was designed below umbilicus. Superficial inferior epigastric artery and vein were anastomosed to the internal mammary artery and vein. Results Since 2007, we have used the superficial inferior epigastric artery flap in 4 cases of breast reconstruction. Four flaps survived completely. With the follow-up of 6-12 months, the reconstructed breasts were well-shaped and there were no complications such as abdominal hernia, bulge and weakness in donor sites. Conclusions Breast reconstruction using the superficial inferior epigastric artery flaps can not only preserve the advantages of the traditional method using the deep inferior epigastric perforator flaps, but also retain the maximal function of the fascia and the rectus abdominal muscle and prevent the occurrence of abdominal weakness and hernia. It is an ideal alternative method of breast reconstruction on condition that definitive preoperative assessment of vessels and skilled surgical technique are provided.%目的 探讨采用腹壁浅动脉(superficial inferior epigastric artery,SIEA)蒂游离腹壁皮瓣乳房再造术方法 、特点及适应证.方法 术前采用多层螺旋CT(multipledetector-row computed tomography,MDCT)三维血管造影及多普勒血流探测仪检查SIEA的直径、走行及分布,于脐与阴阜上缘之间设计皮瓣,采用单蒂或双蒂SIEA,与胸廓内动,静脉吻合,腹部供区直接拉拢缝合.结果 4例乳房再造病例皮瓣全部存活,皮瓣和腹部供区无脂肪液化、坏死、切口裂开、腹壁薄弱及腹壁疝等并发症的出现,再造乳房外形效果满意.结论 SIEA蒂游离腹壁皮瓣与腹

  13. Clinical efficacy of tibia intervention and superfcial femoral artery intervention on patients with severe limb ischemia%严重下肢缺血患者胫骨干预与股浅动脉干预的临床疗效分析

    Institute of Scientific and Technical Information of China (English)

    彭程; 周志勇

    2016-01-01

    目的 探究严重下肢缺血患者胫骨干预与股浅动脉干预的临床疗效. 方法 选取于2009年1月至2014年11月来我院治疗的严重下肢缺血患者137例,分为非胫骨血管成形术组82例,胫骨血管成形术组55例. 详细记录患者一般资料及患者的手术及术后结果,并做统计学分析. 结果 非胫骨血管成形术组和胫骨血管成形术组患者在麻醉方式方面比较具有统计学差异( P0.05). 手术及术后观察指标比较结果表明,非胫骨血管成形术组和胫骨血管成形术组患者在胫骨干预患者TASCⅡ分级、股浅动脉干预再通法、血流动力学变化ABI增加>0.15%方面比较具有统计学差异(P0.05). 结论 胫骨血管成形术组患者TASCⅡ分级更高、股浅动脉干预再通法更为适合、血流动力学变化ABI增加>0.15%病例数增加.%Objective To explore the clinical efficacy of tibia intervention and super? cial femoral artery intervention on patients with severe limb ischemia.Methods 137 cases of severe lower limb ischemia patients treated in our hospital from January 2009 to November 2014 were selected.They were divided into non-tibia interventions group ( n=82) , the tibia intervention group ( n=55) .Patient's general information and surgery and outcomes were recorded, and statistically analyzed.Results There was a significant difference between tibia intervention group and non-tibia intervention group anesthesia methods(P0.05).Difference of TASCⅡ grade, superficial femoral artery recanalization intervention method, hemodynamic changes ABI increasing more than 0.15%between tibia intervention group and non-tibia intervention group was statistically significant ( P0. 05).Conclusions Tibia intervention group has higher TASCⅡgrade, superficial femoral artery recanalization intervention method is more suitable, the number of hemodynamics increase ABI more than 0.15 cases increased.

  14. 股腘动脉血管搭桥术的中西医结合围手术期处理%The Perioperative Care of the Femoral Popliteal Artery Vascular Bypass Operation using Combination of Chinese and Western Medicine

    Institute of Scientific and Technical Information of China (English)

    王秋风; 狄长安

    2013-01-01

    目的:总结股腘动脉人工血管搭桥术治疗股浅动脉闭塞症的中西医结合围手术期处理经验.方法:观察62例股浅动脉闭塞症股腘动脉人工血管搭桥术的中西医结合围手术期处理对疗效的影响.结果:足背动脉搏动恢复,症状消失46例,症状明显改善16例,术后足趾溃疡愈合10例,第一、二趾截趾4例.结论:中西医结合围手术期处理是股腘动脉人工血管搭桥术康复过程中不可忽视的重要环节.%Objective:To summarize the perioperative care experience of combination of Chinese and western medicine on the femoral popliteal artery vascular bypass operation in the treatment of strands of shallow atherosclerosis block. Methods: The impact of perioperative care of Chinese and western medicine on femoral popliteal artery vascular bypass operation for 62 patients with strands of shallow arterial occlusive disease was observed. Results: In terms of pulsation of foot dorsal artery, 46 patients had symptoms disappeared, 16 patients significantly improved, 10 patients had toes ulcer healed, 4 patients had cut the first or the second toes. Conclusion:The perioperative care of combination of Chinese and western medicine is an innegligible important link in the rehabilitation process of the femoral popliteal artery vascular bypass operation.

  15. 股浅静脉第一对瓣膜包窄术治疗原发性下肢深静脉瓣膜功能不全%Treatment of primary deep venous valve insufficiency in lower limb by venous external valvuloplasty on the first valve of superficial femoral vein

    Institute of Scientific and Technical Information of China (English)

    陈寅; 黄惊鸿; 龚景庆

    2001-01-01

    Objective To evaluate the results of treatment of primary deepvenous insufficiency in lower limbs.Methods 55 patients were treated by venous external valvuloplasty on the first valve of superficial femoral vein with PTFE.Results All of the patients were followed up for 4 to 14 months after operation. The results of treatment were very good.Conclusions Primary deep venous valve insufficiency with mild to moderate venous reflux was treated by venous external valvuloplasty on the first valve of superficial femoral vein. It has advantages of few complications and simple operative technique with good results.%目的 评估应用股浅静脉第一对瓣膜包窄术治疗原发性下肢深静脉瓣膜功能不全的疗效。方法 对原发性下肢深静脉瓣膜功能不全的55例患者施以股浅静脉第一对瓣膜包窄术,包窄材料选用聚四氟乙烯人造血管。结果 本组病人术后均随访4~14个月,术前临床症状缓解,疗效好。结论 股浅静脉第一对瓣膜包窄术治疗瓣膜轻、中度倒流的原发性下肢深静脉瓣膜功能不全,有坚实的理论基础,并有并发症少,操作简单,疗效好等优点,值得推广。

  16. Infrascrotal, perineal, femorofemoral bypass for arterial graft infection at the groin.

    Science.gov (United States)

    Illuminati, Giulo; Caliò, Francesco G; D'Urso, Antonio; Giacobbi, Daniela; Papaspyropoulos, Vassilios; Ceccanei, Gianluca

    2004-12-01

    Infrascrotal, perineal, femorofemoral bypass is an acceptable procedure for treating infection of a prosthetic arterial graft limited to a unilateral groin. A consecutive sample clinical study with a mean follow-up of 29 months. The surgical department of an academic tertiary care center and an affiliated secondary care center. Nineteen patients with a mean age of 68 years with prosthetic graft infection at the outflow anastomosis on a femoral artery at the Scarpa triangle underwent an infrascrotal, perineal, femorofemoral bypass, with excision of the graft material limited at the groin. The recipient artery was the profunda femoris artery in 12 cases, the superficial femoral in 5, and the distal common femoral artery in 2. Cumulative survival, recurrence of sepsis, primary graft patency, and limb salvage rates expressed by standard life-table analysis. Postoperative mortality rate was 5%. Cumulative (SE) survival rate was 65% (11.6%) at 3 years. Cumulative (SE) rate of freedom from recurrent sepsis was 88% (8.6%) at 3 years. Cumulative (SE) primary patency and limb salvage rates were 86% (9.4%) and 91% (7.9%), respectively, at 3 years. Femorofemoral bypass with an infrascrotal perineal approach is a valuable procedure for the treatment of femoral arterial graft infection limited at a unilateral groin.

  17. In Situ Aortic Reconstruction with Femoral Vein after Post-EVAR Infection.

    Science.gov (United States)

    Shin, Hong Kyung; Park, Jae Young; Lee, Taeseung

    2014-06-01

    A 78-year-old male presented with early gastric cancer and a 5.5 cm-sized infrarenal abdominal aortic aneurysm, detected during regular screening. Endovascular aneurysm repair (EVAR) was performed first, followed by laparoscopic distal gastrectomy. After gastrectomy, the patient underwent computed tomography (CT) scan due to persistent fever, which showed increased perigraft fluid collection around the right iliac limb graft. Echocardiography also revealed mitral valve vegetation, consistent with infective endocarditis. Despite intensive antibiotic treatment, the patient had persistent fever and showed fluid extension to the psoas muscle on CT scan. On the 49th post operative day (POD) after EVAR, stent graft explantation and aortic reconstruction with the left superficial femoral vein was performed. Ligation of the right iliac artery for infection control and simultaneous femoro-femoral bypass was also performed. The patient was discharged on the 46th POD after graft removal without any events.

  18. Mycotic aneurysm of the popliteal artery as a complication of intravesical BCG therapy for superficial bladder cancer. Case report and literature review.

    NARCIS (Netherlands)

    Witjes, J.A.; Vriesema, J.L.J.; Brinkman, K.; Bootsma, G.P.; Barentsz, J.O.

    2003-01-01

    A 67-year-old man was treated with maintenance intravesical BCG for superficial bladder cancer. As a culture-proven complication of this therapy, he developed general malaise, high fever, granulomatous hepatitis and a mycotic aneurysm in his left knee. All complications were treated successfully wit

  19. Laceration of a branch of the profunda femoris artery caused by a spike of the displaced lesser trochanter in an inter-trochanteric femoral fracture. A case report

    Directory of Open Access Journals (Sweden)

    Vito Potenza

    2016-01-01

    Conclusion: We believe that intertrochanteric femoral fractures with avulsed lesser trochanter are at risk for femoral vessel injuries caused by the displaced bone spike, and we advise meticulous clinical and laboratory monitoring pre- and post-operatively to prevent serious complications.

  20. Contrast-enhanced MRA of the renal and aorto-iliac-femoral arteries: Comparison of gadobenate dimeglumine and gadofosveset trisodium

    Energy Technology Data Exchange (ETDEWEB)

    Iezzi, Roberto [Department of Radiology, Universita G. D' Annunzio, Chieti (Italy); Soulez, Gilles [Centre Hospitalier de L' Universite De Montreal, Montreal (Quebec) (Canada); Thurnher, Siegfried [Department of Radiology, Hospital Brothers of St. John of God, Vienna (Austria); Schneider, Guenther [Department of Diagnostic and Interventional Radiology, University Hospital of Saarland, Homburg/Saar (Germany); Kirchin, Miles A., E-mail: miles.kirchin@bracco.com [Worldwide Medical and Regulatory Affairs, Bracco Imaging SpA, Via E. Folli, 50, Milan 20134 (Italy); Shen, Ningyan; Pirovano, Gianpaolo; Spinazzi, Alberto [Worldwide Medical and Regulatory Affairs, Bracco Diagnostics, Princeton, NJ (United States)

    2011-02-15

    Rationale and objectives: Dedicated contrast agents are now available for contrast-enhanced magnetic resonance angiography (CE-MRA). This study retrospectively compares the safety and diagnostic performance data from Phase III regulatory trials performed to evaluate gadobenate dimeglumine (MultiHance) and gadofosveset trisodium (Vasovist) for renal and peripheral CE-MRA. Materials and methods: Similar examination and blinded assessment methodology was utilized in all studies to determine the safety and diagnostic performance of the agents for detection of significant (>50%) steno-occlusive disease. Digital Subtraction Angiography (DSA) was used as the standard of truth. Diagnostic performance data (sensitivity, specificity, predictive values [PVs], and likelihood ratios [LRs]) were compared (Chi-square test). Results: CE-MRA with gadobenate dimeglumine was more specific (92.4% vs. 80.5%, p < 0.0001) and accurate (83.6% vs. 77.1%, p = 0.022) than CE-MRA with gadofosveset in the detection of significant renal artery stenosis. The average sensitivity was higher for gadofosveset (74.4% vs. 67.3%, p = 0.011) in peripheral vessels although gadobenate dimeglumine was more specific (93.0% vs. 88.2%, p < 0.0001) with no difference in accuracy (86.6% vs. 86.3%, p = 0.66). PPVs were higher (p < 0.0001) for gadobenate dimeglumine in both vascular territories. Pre- to post-test shifts in the probability of detecting significant disease were greater after gadobenate dimeglumine. Adverse events in the renal and peripheral studies were reported by 9.2% and 7.7% of patients after gadobenate dimeglumine compared with 30.3% and 22.1% of patients after gadofosveset. Conclusion: The diagnostic performance of CE-MRA for the detection of significant steno-occlusive disease is similar with gadofosveset and gadobenate dimeglumine although the rate of adverse events appears higher with gadofosveset.

  1. Free superficial peroneal artery perforator flap free transplantation for wound coverage in the hand%腓浅动脉穿支皮瓣游离移植修复手部创面

    Institute of Scientific and Technical Information of China (English)

    杨晓东; 刘杨武; 杨锦; 张根福; 丁茂超; 梅劲; 唐茂林

    2014-01-01

    目的 探讨应用腓浅动脉穿支皮瓣游离移植修复手部创面的临床效果.方法 2008年3月至2012年3月,应用腓浅动脉穿支皮瓣游离移植修复手部创面共9例,其中手掌侧创面4例,虎口区创面1例,手指侧方创面1例,手背创面3例;缺损面积为3.0 cm×4.5 cm~ 5.0 cm×10.0 cm.其中4例与受区桡动脉头静脉吻合,4例与指总动脉浅静脉吻合,1例与尺动脉贵要静脉吻合.5例供区直接缝合,4例供区创面植皮修复.结果 本组9例皮瓣全部存活,未出现血管危象.术后随访3~ 12个月,原缺损部位外形及功能恢复满意,供区外形功能无明显影响.结论 应用腓浅动脉穿支皮瓣游离移植修复手部创面,临床效果满意,值得推广应用.%Objective To investigate the clinical outcomes of repairing wound in the hand with free superficial peroneal artery perforator flap transplantation.Methods From March 2008 to March 2012,9 cases of wound in the hand were treated with free superficial peroneal artery perforator flap transplantation.There were 4 cases of volar defects,1 case of first web space wound,1 case of lateral finger defect and 3 cases of dorsal defects.The size of the wounds ranged from 3.0 cm× 4.5 cm to 5.0 cm × 10.0 cm.The perforator flap vascular pedicle was anastomosed to the radial artery and cephalic vein of the recipient area in 4 cases,to the proper digital artery and superficial vein in 4 cases,and to the ulnar artery and basilic vein in 1 case.The donor site was closed directly in 5 cases and covered with skin graft in 4 cases.Results All of the 9 flaps survived completely.No vascular crisis occurred.Postoperative follow-up ranged from 3 to 12 months.The appearance and function of the repaired sites were satisfactory.Conclusion Free superficial peroneal artery perforator flap transfer for coverage of wound in the hand can lead to satisfactory clinical results.It is an effective method that is worth wide clinical application.

  2. Zygomatico-orbital artery as a recipient vessel for microsurgical head and neck reconstruction.

    Science.gov (United States)

    Higashino, Takuya; Sawamoto, Naoya; Hirai, Rintaro; Arikawa, Masaki

    2013-07-01

    The selection of recipient vessels in head and neck reconstruction is one of the key factors influencing its difficulty and outcome. We report a case of a microsurgical scalp reconstruction using the zygomatico-orbital artery as a recipient vessel.A 71-year-old woman had intractable skin ulcers on her head after neurosurgeries. Computed tomography angiography findings showed that the superficial temporal artery was obstructed and that the zygomatico-orbital artery ran forward and upward. She underwent scalp reconstruction using a free anterior lateral thigh flap. The zygomatico-orbital artery was dissected distally, cut, and turned over cranially. The diameter of the zygomatico-orbital artery was 1.2 mm. The blood flow through the zygomatico-orbital artery was sufficient. The thinned scalp area was excised, and some of the titanium devices and infectious tissues were removed. An anterior lateral thigh flap measuring 20 × 9 cm was harvested and transferred to the defect in the head. The discrepancy in calibers was within double, and the zygomatico-orbital artery fit the descending branch of the lateral circumflex femoral artery. The flap was transferred successfully.The zygomatico-orbital artery is one of the branches from the external carotid artery and supports the suprazygomatic territory. The zygomatico-orbital artery is present in 78% to 92% of people and originates from the superficial temporal artery and sometimes from the frontal branch of superficial temporal artery. The mean diameter of the zygomatico-orbital artery at origin is reported to be 1.20 mm. The zygomatico-orbital artery is another option as a recipient vessel in head and neck reconstruction.

  3. 烧伤脓毒症患者伴行股动脉、股静脉血气变化研究%Changes of accompanying femoral artery and vein blood gas analysis in patients with burn sepsis

    Institute of Scientific and Technical Information of China (English)

    王车江; 刘洪霞; 王宜民; 孟令敏; 张莉; 张庆富

    2015-01-01

    目的:探讨烧伤脓毒症患者伴行股动脉、股静脉血气指标检测的意义。方法总结22例特重度烧伤脓毒症患者(脓毒症组)和43例特重度烧伤未出现脓毒症患者(对照组)的资料,比较2组患者股动脉及股静脉血气指标的变化。结果动脉血气分析:脓毒症组碳酸氢根离子(HCO3-)值低于对照组。静脉血气分析:脓毒症组中股静脉血二氧化碳分压[p(CO2)]高于对照组,股静脉血氧饱和度(SvO2)、HCO3-低于对照组(均P<0.01)。脓毒症组动、静脉氧分压[p(O2)]差值[Δp(O2)],动、静脉p(CO2)差值[Δp(CO2)],动、静脉HCO3-差值(ΔHCO3-),动、静脉血氧饱和度差值(ΔSO2)均高于对照组(均P<0.01)。结论烧伤脓毒症患者股静脉血气指标改变明显,检测股动脉和股静脉血气利于烧伤脓毒症的早期判断。%Objective To discuss changes of accompanying femoral artery and vein blood gas in patients with burn sep⁃sis. Methods The retrospective data of twenty-two patients with burn sepsis and forty-three non-sepsis patients (control) was analyzed, and changes of accompanying femoral artery and vein blood gas were compared between two groups. Results Results of femoral artery gas analysis showed that the HCO3-concentration was lower in sepsis group than that of control group. Results of femoral vein blood gas showed that the partial pressure of carbon dioxide [p(CO2)] was higher in sepsis group than that of control group;the oxygen saturation (SvO2) and HCO3-concentration was lower in sepsis group than that of control group (P<0.01). The differences between oxygen partial pressure p(O2), p(CO2), HCO3-concentration, oxygen satura⁃tion of femoral artery and vein blood gas were significantly higher in sepsis group than those of control group ( P<0.01). Conclusion Results of femoral vein blood gas analysis change obviously in patients with burn sepsis . The detection

  4. 颞浅动脉岛状皮瓣修复重度感染性义眼座暴露%The repair surgery of severe infectious orbital implants exposure with superficial temporal artery island flaps

    Institute of Scientific and Technical Information of China (English)

    杨鸿斌; 刘素芝; 包俊辉; 刘萍

    2013-01-01

    Objective To discuss the method and efficacy of repairment of large severely infectious orbital implants exposure with superficial temporal artery island flaps.Methods To analyse retrospectively the clinical data in ophthalmology department of Xinjiang Hospital of Occupational Disease:6 eyes from 6 cases,with exposure of diameters over 10 mm or concurrent infections in orbital implants.Results After partial penetration and flush for infection control,the patient' s ipsilateral superficial temporal artery island flaps were implanted into the ocular prosthesis to repair the large defect of the conjunctiva sac all at once.All the flaps of 6 cases survived,with stable blood supply,good wear resistance and smooth union with the conjunctiva sac tissues.The ocular prosthesis moved smoothly in all quadrants.Except for the long hair after surgery in 2 cases,no other postoperative complications appeared in the follow-up of 1 to 5 years,with good effect of the treatment.Conclusion The effective partial anti-inflammatory therapy,combined with the superficial temporal artery island flap,is a feasible and effective surgery procedure to repair severe ocular prosthesis exposure and the co-infection.%目的 探讨颞浅动脉岛状皮瓣一次性修复感染性义眼座大面积暴露的方法和效果.方法 新疆职业病医院眼科6例(6眼)义眼座暴露直径>10 mm或合并感染的回顾性分析.结果 经过局部贯穿并冲洗控制感染,取同侧颞浅动脉岛状皮瓣,植入义眼一次性修复大面积结膜囊缺损,6例全部成活,皮瓣血供稳定,耐磨性良好,与结膜囊内组织愈合平整.安装义眼各象限活动自如.术后2例出现毛发过长,需修剪,未见其它术后并发症,随访1~5年,手术效果良好.结论 局部有效抗炎结合颞浅动脉岛状皮瓣,一次性修复严重义眼座暴露合并感染,是可行有效的手术方式.

  5. Free superficial iliac circumflex artery skin flap : the clinical application and management of donor site defects%旋髂浅动脉游离皮瓣的临床应用及供瓣区处理

    Institute of Scientific and Technical Information of China (English)

    韩军涛; 谢松涛; 陶克; 张万福; 计鹏; 胡大海

    2013-01-01

    Objective To investigate the clinical application of free superficial iliac circumflex artery skin flaps,as well as the management of donor site defects.Methods 17 free superficial iliac circumflex artery skin flaps were applied for the traumatic defects or deformities on face,neck,foot,hand,ankle and lower leg,respectively.The donor site defects were closed directly or covered by paraumbilical island flaps.Results The 17 flap size ranged from 5 cm× 3 cm to 19 cm × 14 cm.16 flaps survived completely except 1 flap with partial necrosis,which was closed by free skin graft.The donor site defects were closed directly in 10 cases,and covered by paraumbilical island flaps in 7 flaps without no flap necrosis.The abdomen had a good appearance.Conclusions Good appearance can be achieved with free superficial iliac circumflex artery skin flaps for the dcfects on face,neck,foot,hand,ankle and lower leg.Paraumbilical island flap can be used for the donor site defects.%目的 探讨旋髂浅动脉皮瓣游离移植的临床适应证及供瓣区的修复方法.方法 根据创面大小设计旋髂浅动脉皮瓣,并分别游离移植修复17例面颈部、足踝部及小腿等处创伤及畸形,对供瓣区无法直接拉拢缝合者,设计同侧脐旁岛状皮瓣转移进行修复.结果 17例旋髂浅动脉游离皮瓣,最大面积19 cm×14 cm,最小5 cm×3 cm,16例术后成活良好,1例皮瓣部分坏死,术后2周移植皮片修复.10例供瓣区直接缝合,7例行脐旁岛状皮瓣转移修复,皮瓣全部成活,术后经3个月至2年随访,腹部外形良好.结论 旋髂浅动脉皮瓣游离移植,对于面颈部及手足等处具有良好的修复效果,而同侧脐旁岛状皮瓣亦可使供瓣区得到良好的修复.

  6. Amputated limb by cerclage wire of femoral diaphyseal fracture: a case report.

    Science.gov (United States)

    Won, Yougun; Yang, Kyu-Hyun; Kim, Kwang-Kyoun; Weaver, M J; Allen, Elizabeth M

    2016-12-01

    An entrapment of the femoral artery by cerclage wiring is a rare complication after spiral diaphyseal femoral fractures. We report the case of an 82-year-old female treated by an antegrade intramedullary nailing and multiple cable augmentation, which was then complicated by injury to the femoral artery that resulted in ipsilateral leg necrosis and amputation. The entrapment was caused by direct belting by the cable and resulted in a total obstruction of the femoral artery.

  7. Um novo substituto vascular: arterioplastia femoral em cães com remendo de membrana de biopolímero de cana-de-açúcar - avaliação hemodinâmica e histopatológica A new vascular substitute: femoral artery angioplasty in dogs using sugarcane biopolymer membrane patch - hemodynamic and histopathologic evaluation

    Directory of Open Access Journals (Sweden)

    Silvio Romero de Barros Marques

    2007-12-01

    Full Text Available CONTEXTO: A obtenção de um substituto arterial ideal para o emprego nas reconstruções das artérias de pequeno e médio calibre é ainda o principal objetivo da maioria das pesquisas científicas desenvolvidas no campo dos substitutos vasculares. A membrana de biopolímero de cana-de-açúcar pode ser de grande utilidade para a realização das reconstruções arteriais em vasos de calibre inferior a 4 mm e assim permitir o tratamento de doenças que afetam milhões de pessoas no Brasil e em todo o mundo. OBJETIVO: Avaliar do ponto de vista hemodinâmico e histopatológico o comportamento da membrana do biopolímero de cana-de-açúcar quando utilizada com remendo em arterioplastias femorais em cães. MÉTODO: Oito cães adultos mestiços sob anestesia geral foram submetidos no Núcleo de Cirurgia Experimental do Centro de Ciências da Saúde-UFPE a velocimetria Doppler percutânea das artérias femorais direita e esquerda para controle pré-operatório. Sob condições de assepsia e anti-sepsia, os cães foram submetidos a arterioplastia femoral bilateral com remendos da membrana de biopolímero de cana-de-açúcar no lado esquerdo e de PTFE expandido (e-PTFE no lado direito. Na primeira semana pós-operatória, os cães foram submetidos a avaliação clínica diária e semanal a partir do oitavo dia. A avaliação clínica consistiu no exame dos pulsos femorais, na avaliação da marcha e na observação da presença de tumor pulsátil, hematoma ou hemorragia e infecção da ferida operatória. Após 180 dias das arterioplastias, sob anestesia geral, procedeu-se nova fluxometria Doppler percutânea das artérias femorais. Os animais foram submetidos à dissecção das artérias femorais, medido o diâmetro arterial e realizada velocimetria Doppler trans-operatória em pontos proximal e distal à arterioplastia. A seguir foi realizada laparotomia e exposição da aorta abdominal para acesso arteriográfico. Os segmentos das art

  8. A pitfall in the measurement of arterial blood pressure in the ischaemic limb during elevation

    DEFF Research Database (Denmark)

    Bülow, J; Jelnes, Rolf

    1987-01-01

    In order to evaluate if elevation of the ischaemic limb above heart level is an alternative to the conventionally applied method with external counterpressure for estimation of skin perfusion pressure, femoral and popliteal artery pressures were measured directly in eight patients with occlusion...... of the superficial femoral artery. The measurements were done in the horizontal position and during elevation of the calf above heart level. During elevation relative blood flow, measured by arterio-venous oxygen saturation differences, decreased compared with the horizontal position. In contrast the popliteal...... arterial pressure decreased only by 20% of the value expected from the degree of elevation of the calf above the level of the heart. Thus, it could be calculated that calf vascular resistance increased two- to three-fold on average during elevation. Four patients were reexamined with the venous pressure...

  9. 超声在兔股动脉血栓模型评价中的价值%Value of ultrasonography in evaluating the femoral artery thrombosis in rabbits

    Institute of Scientific and Technical Information of China (English)

    郭朝锋; 穆玉明; 关丽娜; 唐琪

    2010-01-01

    目的 探讨超声在兔股动脉血栓模型评价中的应用价值.方法 选取20只新西兰大白兔,应用三氯化铁外敷联合夹闭法建立兔双侧股动脉血栓模型,用超声和血流仪评价血栓形成情况,以病理结果作为金标准,分析两种方法与病理结果的一致性.结果 共32条股动脉成功建立血栓模型,其中19条股动脉形成闭塞性血栓.超声诊断血栓形成与病理结果高度一致(Kappa值0.720,P<0.001);血流仪诊断血栓形成与病理结果中度一致(Kappa值0.546,P<0.001).超声和血流仪诊断闭塞性血栓形成与病理结果均高度一致(Kappa值分别为0.800、0.798,P均<0.001).结论 超声在兔动脉血栓模型评价中与病理结果具有高度的一致性,在非闭塞性血栓的诊断中优于血流仪诊断.%Objective To investigate the value of ultrasonography in evaluating the femoral artery thrombosis in rabbit. Methods Thrombosis was induced by external application with 10% ferric chloride and transient femoral artery-occlusion with bulldog clamp in twenty New-Zealand rabbits. The thrombosis was monitored by both Doppler flowmeter and ultrasonography. The histopathological result was used as the golden standard. The consistency of the above two results with the golden standard was analyzed. Results Thirty-two femoral arteries thrombosis were produced successfully. There was high consistency between the results of ultrasonic evaluation and histopathological examination (Kappa = 0. 720, P < 0. 001 ), and moderate consistency between the results of Doppler flowmeter evaluation and histopathological examination (Kappa = 0. 546, P <0. 001 ). Within the thirty-two femoral arteries thrombosis, there were nineteen arteries with occlusive thrombus examined by histopathological means. Both the results of Doppler flowmeter and ultrasonography were highly consistent with the results of histopathological examination (Kappa = 0. 800 and 0.798 respectively, P < 0. 001

  10. Safety and efficacy of coronary drug eluting stent for atherosclerotic stenosis of the small renal artery

    Institute of Scientific and Technical Information of China (English)

    LI Chun-jie; WU Zheng; YAN Hong-bing; WANG Jian; ZHAO Han-jun

    2009-01-01

    @@ Small diameter renal artery refers to the renal artery with the cross-section diameter less than 5 mm, the incidence of which is approximately 8%.1 Small diameter renal artery is common in patients with congenital multi-branch renal arteries, diabetes and multi-coronary artery lesions. Renal artery bare-mental stent (BMS) implantation is the standard treatment for ostial renal artery stenosis.2,3 However, the restenosis rate4-6 is too high and becomes one of the relative contraindications for small diameter renal artery stent implantation. Clinical trials (e.g. RAVEL,7,8 SIRIUS9 and TAXUS-IV10) have proved that drug eluting stent (DES), compared with BMS, can reduce the restenosis rate after the percutanous coronary intervention (PCI). And Huda et al11 claimed that DES had the better results than BMS in the treatment of obstructive superficial femoral artery disease. However,there are few studies involved restenosis after the renal artery intervention. We hypothesized that coronary DES applied in renal artery stenosis might inhibit intimal proliferation effectively as in coronary artery disease;therefore we evaluated the results of 25 patients with atherosclerotic renal artery stenosis treated using coronary DES to assess the safety and efficacy of coronary DES in patients with small renal artery stenotic lesions.

  11. 经动脉骨髓干细胞移植治疗股骨头坏死61例%The artery transplantation of bone marrow stem cells to treat 61 cases of femoral head necrosis

    Institute of Scientific and Technical Information of China (English)

    高泽锋; 王娜; 许楠; 崔庆明; 曹晓芙

    2015-01-01

    目的:研究分析经动脉骨髓干细胞移植治疗股骨头坏死的临床效果。方法选取该院骨科2012年9月—2013年9月收治的61例股骨头坏死的患者,给予所有患者经动脉骨髓干细胞移植治疗,观察患者的临床治疗效果。结果所有患者通过治疗后,53例髋关节疼痛具有不同程度的缓解,占86.9%。其中行走间距延长的患者有33例,占54.1%;关节功能有所改善的患者有20例,占32.8%。患者的生活质量得到较好的提高,其总有效率为86.9%。结论针对股骨头坏死的患者,采取经动脉骨髓干细胞移植治疗,其操作方法简便、安全有效,在治疗的时候没有不良反应,其是治疗股骨头坏死的理想方式。%Objective Research and analysis the artery of the bone marrow stem cell transplantation for treatment of femoral head necrosis. Methods Select our hospital between September 2012 and September 2012 were 61 cases of patients with femoral head necrosis, giving all the artery in patients with bone marrow stem cell transplantation therapy, observe the clinical therapeutic effect of patients. Results With patients after treatment, 53 cases of the hip joint with different degree of pain relief, and accounted for 86.9%. 33 cases of patients with walking distance to extend, accounted for 54.1%; Joint function improvement in 20 cases of pa-tients, accounting for 32.8%. The patientˊs quality of life for the better, the total effective rate was 86.9%. Conclusion Via artery approaches for the patients with femoral head necrosis, bone marrow stem cell transplant treatment, its operation method is simple, safe and effective, and in the treatment of no adverse reaction, it is an ideal way to treat femoral head necrosis.

  12. A unique variation of superficial palmar arch

    Directory of Open Access Journals (Sweden)

    Jiji PJ

    2009-09-01

    Full Text Available We present a unique variation in the arterial pattern of superficial palmar arch in which it was completed by one of the large terminal branches of radial artery. The origin of the arteria radialis indicis was also peculiar that it was arising from the communicating branch of the radial artery and further reinforced by the first dorsal metacarpal artery that joined it after reaching the volar aspect. Pertinent anatomical knowledge regarding the variations of the palmar arch is significant for the purposes of microvascular repairs and re-implantations.

  13. Interação entre as vias de sinalização de receptores serotoninérgicos e Β-adrenérgicos em artéria femoral de ratos Interacción entre las vías de señalización de receptores serotoninérgicos y β-adrenégicos en la arteria femoral de ratones Interaction between serotoninergic-and β-adrenergic receptors signaling pathways in rat femoral artery

    Directory of Open Access Journals (Sweden)

    Maria Andréia Delbin

    2012-01-01

    Full Text Available FUNDAMENTO: A doença coronária tem sido amplamente estudada em pesquisas cardiovasculares. No entanto, pacientes com doença arterial periférica (DAP têm piores resultados em comparação àqueles com doença arterial coronariana. Portanto, os estudos farmacológicos com artéria femoral são altamente relevantes para a melhor compreensão das respostas clínicas e fisiopatológicas da DAP. OBJETIVO: Avaliar as propriedades farmacológicas dos agentes contráteis e relaxantes na artéria femoral de ratos. MÉTODOS: As curvas de resposta de concentração à fenilefrina contrátil (FC e à serotonina (5-HT e os agentes relaxantes isoproterenol (ISO e forskolina foram obtidos na artéria femoral de ratos isolada. Para as respostas ao relaxamento, os tecidos foram contraídos com FC ou 5-HT. RESULTADOS: A potência de classificação na artéria femoral foi de 5-HT > FC para as respostas contráteis. Em tecidos contraídos com 5-HT, as respostas de relaxamento ao isoproterenol foram praticamente abolidas em comparação aos tecidos contraídos com FC. A forskolina, um estimulante da adenilil ciclase, restaurou parcialmente a resposta de relaxamento ao ISO em tecidos contraídos com 5-HT. CONCLUSÃO: Ocorre uma interação entre as vias de sinalização dos receptores β-adrenérgicos e serotoninérgicos na artéria femoral. Além disso, esta pesquisa fornece um novo modelo para estudar as vias de sinalização serotoninérgicas em condições normais e patológicas que podem ajudar a compreender os resultados clínicos na DAP.FUNDAMENTO: La enfermedad coronaria ha sido ampliamente estudiada en las investigaciones cardiovasculares. Sin embargo, los pacientes con enfermedad arterial periférica (EAP, tienen los peores resultados en comparación con aquellos con la enfermedad arterial coronaria. Por tanto, los estudios farmacológicos con la arteria femoral son extremadamente importantes para obtener una mejor comprensión de las respuestas cl

  14. 超声检测股动脉、腹主动脉及颈动脉粥样硬化与冠状动脉粥样硬化的相关性%Ultrasound study on correlation between atherosclerosis of femoral artery, abdominal aorta and carotid artery and coronary atherosclerosis

    Institute of Scientific and Technical Information of China (English)

    孙建群; 刘颖

    2012-01-01

    目的:探讨股动脉、腹主动脉及颈动脉粥样硬化与冠状动脉粥样硬化的相关性.方法:采用高频超声测量109例行冠状动脉造影术后1周的患者股动脉、腹主动脉及颈动脉的内-中膜厚度(IMT)、斑块积分及斑块数目.结果:股动脉、腹主动脉及颈动脉粥样硬化与冠状动脉粥样硬化呈正相关(P<0.01、P<0.05);股动脉斑块预测冠状动脉粥样硬化的灵敏度为89%,特异度为77%,准确度84%;腹主动脉斑块预测冠状动脉粥样硬化的灵敏度为73%,特异度为72%,准确度72%;颈动脉斑块预测冠状动脉粥样硬化的灵敏度为83%,特异度为79%,准确度82%.结论:超声检查股动脉、腹主动脉及颈动脉IMT及斑块可间接预测不同程度的冠状动脉粥样硬化;股动脉的灵敏度与准确度较腹主动脉更好.%AIM; To explore the correlation between atherosclerosis of femoral artery, abdominal aorta and carotid artery and coronary atherosclerosis using ultrasound. METHODS; The film thickness within (IMT, intima-media thickness) , patch integral and plaque numbers of the femoral artery, abdominal aorta and carotid artery were measured by ultrasound in 109 patients 1 week after coronary angiography. RESULTS: Atherosclerosis of the femoral artery, abdominal aorta and carotid artery were positively correlated with coronary atherosclerosis (P <0. 01, P <0. 05) . Sensitivity of the femoral artery plaque and coronary atherosclerosis was 88. 6% and specificity was 76. 9%. Sensitivity of abdominal aorta plaque and coronary atherosclerosis was 72. 9% and specificity was 71. 8%. Sensitivity of carotid artery plaque and coronary atherosclerosis was 82. 9% and specificity was 79. 5%. CONCLUSION; Ultrasonic imaging and detection of the femoral artery, abdominal aorta and carotid artery IMT and plaque can indirectly predict the different degrees of coronary atherosclerosis.

  15. 颞浅动脉顶支扩张岛状皮瓣在修复头皮缺损中的应用%Application of the parietal branches of superficial temporal artery island flap in complex scalp defects

    Institute of Scientific and Technical Information of China (English)

    王楷; 李爱林; 赵月强; 余墨声; 罗定安; 吴晓蔚

    2013-01-01

    Objective To investigate the application of the parietal branches of superficial temporal artery island flap in the complex scalp defects.Methods A parietal branches of superficial temporal artery island flap on the ectatic scalp flap was designed to repair the complex scalp defects in 25cases and the repairing effect was observed.Results The island flaps were survived completely in 24patients,in which 1 patient had partial necrosis because of the flap tension was too large,but healed after local dressing and debridement.After followed up 6~ 12 months,the color and texture of the flap were the same to the surrounding normal scalp,and the shape was satisfactory.The flap donor site of hair growth was good,with well healing and no obvious complications.Conclusions The parietal branches of superficial temporal artery island flap can repair the complex scalp defects with the flexible flap design and movement.The flap survives well and the repair area is large.The flap and the surrounding scalp connects good.Therefore,it is a good method strongly recommended for small area complex scalp defects repair in clinics.%目的 探讨颞浅动脉顶支扩张岛状皮瓣在修复复杂头皮缺损中的应用.方法 通过在扩张头皮瓣上设计以颞浅动脉顶支为蒂的岛状皮瓣,转移修复复杂头皮缺损25例,并观察其愈合和修复效果.结果 25例患者,24例皮瓣完全存活,1例患者因皮瓣张力过大出现部分坏死,但通过清创及换药后愈合.术后随访6~12个月,头皮缺损修复部位与周围皮肤色泽、质地相似,外形恢复满意,皮瓣供受区毛发生长良好,创面愈合良好,无并发症发生.结论 应用颞浅动脉顶支为蒂的岛状扩张皮瓣修复复杂头皮缺损,皮瓣存活良好,皮瓣设计、转移灵活,修复范围较大,皮瓣与周边头皮衔接良好,是修复复杂头皮缺损的一种良好方法,值得应用和推广.

  16. 多功能集成化股静脉置管管道装置在动物实验中的应用%Application of the multifunctional integrated tubular pipeline in femoral artery and vein in animal experiments

    Institute of Scientific and Technical Information of China (English)

    谭莉; 汉瑞娟

    2013-01-01

    Objective To evaluate the application results of the multifunctional integrated tubular pipeline in femoral artery and vein in animal experiments. Methods The self-made multifunctional integrated tubular pipeline was used in the femoral artery and vein in 31 dogs with severe multiple wounds. The total time consumption and efficacy of five procedures, i.e. blood transfusion, fluid infusion, blood sampling, drug administration, and measurement of central venous pressure were observed. Results The average total time consumption of the 5 procedures was 80 ± 12 seconds , significantly shorter than that of routine procedure (216 ±48 seconds) , and the average time consumption of each item was 19 ±5.1 seconds, also significantly shorter than that of routine procedure (56 ±6.8 seconds). Conclusions The application of multifunctional integrated tubular pipeline in the femoral artery and vein saves time and human resources and works quickly and conveniently in animal experiments. Therefore , it is worth a wide application and dissemination.%目的 探讨多功能集成化股静脉置管管道装置在动物实验中的应用效果.方法 在31例严重多发伤动物实验中,应用自制的多功能集成化股静脉置管管道装置,观察实验过程中输血、输液、采集血样、静脉给药、中心静脉压测定五项护理技术操作全程顺序进行项目完成的时间和效果.结果 在动物实验中应用多功能集成化股静脉置管管道装置,五项护理技术操作全程顺序进行平均每次时间为(80±12)s,平均每项次时间(19±5.1)s.结论 多功能集成化股静脉置管管道装置在动物实验中应用,省时、省力、快捷、方便,值得进一步应用推广.

  17. 人股动脉粥样硬化相关蛋白的鉴定及其生物学作用%Proteomics analysis on pathogenesis of human atherosclerosis obliterans in human femoral artery

    Institute of Scientific and Technical Information of China (English)

    赵振; 赵海光; 蒋米尔

    2011-01-01

    Objective We used proteomic profiling in an attempt to differentiate and identify histological proteins that were associated with atherosclerosis obliterans (ASO) of human femoral artery.Methods We comparatively analyzed the proteome of 8 atherosclerotic and 5 normal femoral arteries. The differentially expressed proteins were visualized by two dimensional electrophoresis (2-DE) and sequenced by matrix assisted laser desorption/ionization mass spectrometry (MALDI-TOF-MS). The protein identification program was used to search the National Center for Biotechnology Information (NCBI) database and International Protein Index (IPI). Results A total of 53 distinct spots corresponding to 13 different proteins were identified by MALDI-TOF-MS using the NCBI and IPI databases. The function information of these 13 proteins mainly involved the pathogenetic mechanisms such as inflammation, innate immunity, oxidative stress, lipid metabolism, amyloid degeneration and so on. Conclusion ASO is associated with distinct patterns of protein expression in the femoral arteries, and differentially expressed 13 proteins may contribute to the pathogenesis. These findings might provide needed biomarkers for ASO and new insight into its pathophysiology.%目的 应用比较蛋白质组学方法探讨人动脉粥样硬化闭塞症(ASO)差异蛋白质的表达及其在ASO发病机制中的作用.方法 选取ASO股动脉8例及正常股动脉5例,提取组织蛋白质,行双向凝胶电泳分离、质谱分析及数据库查询,获得差异蛋白信息.结果 成功建立ASO和正常股动脉双向电泳图谱,含量相差大于2倍以上的蛋白质53个,27个上调,26个下调,质谱鉴定出13种蛋白质,主要与炎症、免疫、氧化应激、脂质代谢等相关.结论 ASO与正常股动脉蛋白质组明显差异,差异蛋白质可能在ASO中起重要作用.

  18. Mechanical evaluation of anastomotic tension and patency in arteries.

    Science.gov (United States)

    Zhang, F; Lineaweaver, W C; Buntic, R; Walker, R

    1996-02-01

    This study quantified arterial anastomotic tension, evaluated subsequent patency rates, and examined the degree of tension reduction with vessel mobilization. The study was divided into two components. In part I, a mechanical analysis was undertaken to evaluate tension, based on the determination of the force required to deflect a cable (vessel) laterally, and its resulting lateral displacement. Six Sprague-Dawley rats with 12 femoral arteries were divided into two subgroups: 1) no mobilization; and 2) axial mobilization by ligation and transection of superficial epigastric and gracilis muscular branches. The tension of femoral arterial anastomoses was calculated in vessels with no segmental defect and with 1.5-, 3-, 4.5-, 6-, and 7.5-mm defects. In part II, patency was evaluated. Fifty-five rats with 110 femoral arteries were divided into two sub-groups as defined in part I: 1) no mobilization; and 2) axial mobilization by ligation and transection of superficial epigastric and gracilis muscular branches. Microvascular anastomoses were performed with no segmental defect and with 1-, 2-, 3-, 4-, 5-, 6-, 7-, 8-, 9-, and 10-mm segmental vessel defects. Patency was evaluated 24 hr postoperatively. Part I of the study revealed that anastomotic tension gradually increased along with an increase in the length of the vessel defect, from 1.9 to 11.34 g in the no-mobilization group and from 1.97 to 8.44 g in the axial-mobilization group. Comparison of tension linear regression coefficient showed a significant difference between the two groups (p tension approximately 6 g) in the no-mobilization group and 6 mm in the axial-mobilization group (tension approximately 6.48 g). Microanastomotic tension was related to the size of the vessel defect, with increasing tension leading to thrombosis. Axial mobilization significantly reduced the tension in vessels with segmental defects and decreased thrombosis rates.

  19. The Evaluation of Neptune Pad in Hemostasis of Femoral Artery Puncture Point after Interventional Therapy for 25 Patients Aged Over 80 with Cancer%25例超高龄癌症患者股动脉穿刺点Neptune Pad止血贴应用评价

    Institute of Scientific and Technical Information of China (English)

    刘建文; 张同庆; 张怡; 赵丹; 孟娥; 贾晨星; 梁仲侨

    2013-01-01

      目的探讨80岁以上超高龄癌症患者经股动脉穿刺介入治疗后应用Neptune Pad止血贴的疗效及安全性。方法25例(共52次)超高龄癌症患者的股动脉穿刺点应用Neptune Pad止血贴辅助止血。结果52次经股动脉穿刺动脉灌注化疗和/或栓塞后,均无穿刺处并发症发生。结论 Neptune Pad止血贴对超高龄患者的股动脉穿刺止血效果肯定、安全可靠。%  Objective To investigate the safety and efficacy of the Neptune Pad in hemostasis of femoral artery puncture point after interventional therapy. Methods The application of Neptune Pad was 52 times in hemostasis of femoral artery puncture point after interventional therapy for 25 patients aged over 80 with cancer. Results There were no puncture complications in 52 times femoral artery puncture after interventional therapy. Conclusion The application of Neptune Pad for patients aged over 80 with femoral artery puncture haemostatic are effectively and safety.

  20. Emergency and elective implantation of covered stent systems in iatrogenic arterial injuries

    Energy Technology Data Exchange (ETDEWEB)

    Goltz, J.P.; Kickuth, R. [Universitaetsklinikum Wuerzburg (Germany). Inst. fuer Roentgendiagnostik; Bastuerk, P.; Hoppe, H.; Triller, J. [Universitaetsspital Bern (Switzerland). Inst. fuer Diagnostische, Interventionelle und Paediatrische Radiologie

    2011-07-15

    Purpose: To evaluate the effectiveness and safety of covered stents for the management of iatrogenic arterial injury. Materials and Methods: Between 03/1998 and 12/2009, 31 patients underwent selective covered stent implantation after iatrogenic arterial injury. 12/31 of these patients (38.7 %) were hemodynamically unstable. Six different endovascular covered stent types were utilized. The primary endpoints of this study were technical and clinical success and rates of minor and major complications. Results: Initial angiograms demonstrated active extravasation in 19 (61.3 %) patients and pseudoaneurysms in 12 (38.7 %) patients. The following sites of bleeding origin were detected: axillary artery, subclavian artery, common iliac artery, external iliac artery, internal iliac artery, common femoral artery, superficial femoral artery, popliteal and fibular artery, femoro-popliteal and popliteo-crural bypasses, common hepatic artery, aberrant hepatic artery, cystic and gastroduodenal artery. In all patients bleeding was effectively controlled by covered stent implantation resulting in an immediate technical success of 100 %. Clinical success attributed to covered stent implantation was documented in 30 of the 31 patients (96.8 %). Major complications included death in four patients (11.1 %), acute thrombosis with arm ischemia in one patient (2.8 %) and stent fracture with associated pseudoaneurysm in another patient (2.8 %). In 2/31 patients (6.5 %) covered stent failure was detected and successfully treated by implantation of a second covered stent. Conclusion: Emergency and elective implantation of covered stents may be used for minimally invasive and effective management of iatrogenic arterial injury. (orig.)

  1. Modified superficial peroneal neurocutaneous flap pedicled with lateral supramalleolar artery arising from peroneal artery for forefoot defect%跨区供血腓动脉外踝上穿支蒂腓浅神经营养血管皮瓣修复足前部缺损

    Institute of Scientific and Technical Information of China (English)

    陈雪松; 肖茂明; 王元山; 管力; 张黎明; 江珉

    2010-01-01

    Objective To report the operative techniques and clinical results of modified distally based superficial peroneal neuroeutaneous flap for skin defect of the forefoot. Methods A reversed superficial peroneal nerocutaneous flap pedicled with the lateral superamalleolar perforating artery or its descending branch, which vascularized the flap through the nutrient vessel chain of the nerve, which linked vascular territories of superamalleolar perforating artery, cutaneous branches of the anterior tibial artery and superficial peroneal artery, was designed to repair skin defects in the forefoot. Results The modified flaps were applied in 17 cases. All flaps were survived successfully with no complication. The largest size of the flap was 20 cm × 8 cm. The flap could reach as far as the proximal end of the second and third toes or weight-bearing areas under the fifth metatarsal caput. Conclusions The modified flap has reliable blood supply with a relatively large size and long rotation are. It is a simple and safe for covering medium to large defects in the forefoot.%目的 探讨改良腓浅神经营养血管皮瓣修复足前部缺损的手术方法及临床效果.方法 对足前部皮肤软组织缺损创面,设计切取以外踝上穿支或其降支为蒂,经其升支、胫前动脉皮穿支及腓浅动脉跨区供血的腓浅神经营养血管皮瓣修复.结果 2005年2月至2008年2月,于临床应用17例,最远修复至第2、3趾基底部及第5跖骨头负重区,最大切取面积20 cm×8 cm;皮瓣均全部成活,术后随访6~12个月,皮瓣质地优良,外形与足踝功能恢复满意.结论 该皮瓣神经血管丛粗大而丰富,蒂部供血确切,旋转修复距离可达足趾,适用于涉及足前部的足背中、大面积皮肤软组织缺损的修复.

  2. UNILATERAL INCOMPLETE SUPERFICIAL PALMAR ARCH: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Subhankar Chakraborty

    2015-12-01

    Full Text Available The functional importance of hand is revealed by its rich vascularity contributed by superficial and deep palmar arches (SPA and DPA.Superficial palmar arch is located superficial to flexor tendons, and deep palmar arch deep to lumbrical muscles. Variations are found more often in SPA than DPA, later being more or less constant. During routine undergraduate dissection, we observed, unilateral incomplete SPA being formed by superficial palmar branches of ulnar and radial artery in the right hand of a male cadaver. These two arteries remained independent without anastomosis forming incomplete arch (SPA.The superficial branch of ulnar artery entered hand superficial to flexor retinaculum and supplied middle, ring and little finger by three branches. The superficial branch of radial artery via its two branches supplied index finger and thumb. Classical SPA formation was seen on left side. The presence of an incomplete SPA as in this case is a potential danger in RA harvesting for CABG.Variations in SPA play a pivotal role in microvascular surgical procedures of hand, RAinterventions and arterial graft applications.

  3. The dangers of damage control orthopedics: a case report of vascular injury after femoral fracture external fixation

    Directory of Open Access Journals (Sweden)

    Staeheli Gregory R

    2012-03-01

    Full Text Available Abstract Background Placement of external fixation frames is an expedient and minimally invasive method of achieving bone and joint stability in the setting of severe trauma. Although anatomic safe zones are established for placement of external fixation pins, neurovascular structures may be at risk in the setting of severe trauma. Case report We present a case of a 21-year-old female involved in a high speed motorcycle accident who sustained a Type IIIB open segmental femur fracture with significant thigh soft tissue injury. Damage control orthopedic principals were applied and a spanning external fixator placed for provisional femoral stabilization. Intraoperative vascular examination noted absent distal pulses, however an intraoperative angiogram showed arterial flow distal to the trifurcation. Immediately postoperatively the dorsalis pedis pulse was detected using Doppler ultrasound but was then non-detectable over the preceding 12-hours. Femoral artery CT angiogram revealed iatrogenic superficial femoral artery occlusion due to kinking of the artery around an external fixator pin. Although the pin causing occlusion was placed under direct visualization, the degree of soft tissue injury altered the appearance of the local anatomy. The pin was subsequently revised allowing the artery to travel in its anatomic position, restoring perfusion. Conclusion This case highlights the dangers associated with damage control orthopedics, especially when severe trauma alters normal local anatomy. Careful assessment of external fixator pin placement is crucial to avoiding iatrogenic injury. We recommend a thorough vascular examination pre-operatively and prior to leaving the operating room, which allows any abnormalities to be further evaluated while the patient remains in a controlled environment. When an unrecognized iatrogenic injury occurs, serial postoperative neurovascular examinations allow early recognition and corrective actions.

  4. Magnetic Resonance Venous Volume Measurements in Peripheral Artery Disease (from ELIMIT).

    Science.gov (United States)

    Kamran, Hassan; Nambi, Vijay; Negi, Smita; Yang, Eric Y; Chen, Changyi; Virani, Salim S; Kougias, Panos; Lumsden, Alan B; Morrisett, Joel D; Ballantyne, Christie M; Brunner, Gerd

    2016-11-01

    The relation between the arterial and venous systems in patients with impaired lower extremity blood flow remains poorly described. The objective of this secondary analysis of the Effectiveness of Intensive Lipid Modification Medication in Preventing the Progression on Peripheral Artery Disease Trial was to determine the association between femoral vein (FV) volumes and measurements of peripheral artery disease. FV wall, lumen, and total volumes were quantified with fast spin-echo proton density-weighted magnetic resonance imaging scans in 79 patients with peripheral artery disease over 2 years. Reproducibility was excellent for FV total vessel (intraclass correlation coefficient 0.924, confidence interval 0.910 to 0.935) and lumen volumes (intraclass correlation coefficient 0.893, confidence interval 0.873 to 0.910). Baseline superficial femoral artery volumes were directly associated with FV wall (r = 0.46, p <0.0001), lumen (r = 0.42, p = 0.0001), and total volumes (r = 0.46, p <0.0001). The 2-year change in maximum walking time was inversely associated with the 24-month change in FV total volume (r = -0.45, p = 0.03). In conclusion, FV volumes can be measured reliably with fast spin-echo proton density-weighted magnetic resonance imaging, and baseline superficial femoral artery plaque burden is positively associated with FV volumes, whereas the 2-year change in FV volumes and leg function show an inverse relation.

  5. 颞浅动脉组织瓣修复儿童头面部畸形%REPAIRING DEFORMITY OF THE HEAD AND FACE WITH TISSUE FLAP PEDICLED WITH THE SUPERFICIAL TEMPORAL ARTERY IN CHILDREN

    Institute of Scientific and Technical Information of China (English)

    傅跃先; 向代理; 张显文; 邱林; 唐毅; 王珊

    2001-01-01

    目的 评价颞浅动脉组织瓣在修复儿童头面部畸形中的作用。方法 1986年10月~1996年12月,采用颞浅动脉组织瓣修复13例儿童头面部畸形,其中先天性畸形9例,烧伤瘢痕3例,感染后瘢痕1例。采用颞部皮瓣1例,颞部毛发皮瓣3例,额部皮瓣1例,耳后浅筋膜瓣与皮瓣8例。组织瓣大小为5.0 cm×1.2 cm~10.0 cm×5.0 cm,皮瓣蒂长5~8 cm。结果 术后组织瓣均Ⅰ期愈合。术后10例获得随访,时间6个月~12年,皮瓣色泽似邻近皮肤,质地柔软,厚薄适中,毛发瓣毛发生长良好,耳后浅筋膜瓣与皮瓣满足耳再造需要。所有病例术后切口瘢痕隐蔽,外观获明显改善。结论 颞浅动脉组织瓣血供丰富,邻近受区,易操作且形态良好,适用于儿童头面部多种畸形的修复。%Objective To evaluate the effect of tissue flap pedicled with the superficial temporal artery in repairing deformity of the head and face in children. Methods From October 1986 to December 1996, 13 children with deformity of the head and face were repaired by this tissue flap. Among them, there were congenital deformity in 9 cases, burned scar in 3 cases and infection scar in 1 case. Among the flaps, 1 was temporal skin flap, 3 were temporal flap with hairbearing scalp, 1 was frontal skin flap, and 8 were posterio-uricular superficial fascia flap and skin flap. The area of tissue flap was ranged from 5.0 cm×1.2 cm to 10.0 cm×5.0 cm. The length of the pedicle was 5~8 cm. Results All tissue flaps healed with first intention. Followed up for 6 months to 12 years, the appearance and function of tissue flaps were satisfactory. Conclusion The tissue flap pedicled with the superficial temporal artery is suitable to repair many kinds of deformities of the head and face in children. It has the advantages of good blood supply, closely acceptor area, easy operation and satisfactory appearance.

  6. Direct quantitative assessment of the peripheral artery collateral circulation in patients undergoing angiography.

    Science.gov (United States)

    Traupe, Tobias; Ortmann, Jana; Stoller, Michael; Baumgartner, Iris; de Marchi, Stefano F; Seiler, Christian

    2013-08-13

    Despite the fact that numerous studies have pursued the strategy of improving collateral function in patients with peripheral artery disease, there is currently no method available to quantify collateral arterial function of the lower limb. Pressure-derived collateral flow index (CFIp, calculated as (occlusive pressure-central venous pressure)/(aortic pressure-central venous pressure); pressure values in mm Hg) of the left superficial femoral artery was obtained in patients undergoing elective coronary angiography using a combined pressure/Doppler wire (n=30). Distal occlusive pressure and toe oxygen saturation (Sao2) were measured for 5 minutes under resting conditions, followed by an exercise protocol (repetitive plantar-flexion movements in supine position; n=28). In all patients, balloon occlusion of the superficial femoral artery over 5 minutes was painless under resting conditions. CFIp increased during the first 3 minutes from 0.451±0.168 to 0.551±0.172 (P=0.0003), whereas Sao2 decreased from 98±2% to 93±7% (P=0.004). Maximal changes of Sao2 were inversely related to maximal CFIp (r(2)=0.33, P=0.003). During exercise, CFIp declined within 1 minute from 0.560±0.178 to 0.393±0.168 (Psupply-demand mismatch via collaterals or, alternatively, a steal phenomenon. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. UNIQUE IDENTIFIER: NCT01742455.

  7. The specific role of gravitational accelerations for arterial adaptations.

    Science.gov (United States)

    Weber, Tobias; Ducos, Michel; Mulder, Edwin; Herrera, Frankyn; Brüggemann, Gert-Peter; Bloch, Wilhelm; Rittweger, Jörn

    2013-02-01

    It is mostly agreed that arterial adaptations occur, among others, in response to changes in mechanical stimuli. Models like bed rest, spinal cord injury, or limb suspension have been applied to study vascular adaptations to unloading in humans. However, these models cannot distinguish the role of muscle contractions and the role of gravitational accelerations for arterial adaptation. The HEPHAISTOS orthosis allows normal ambulation, while it significantly reduces force generation in the lower leg muscles. Eleven subjects wore HEPHAISTOS unilaterally for 56 days and were followed up for another 4 wk. Arterial diameters, intima media thickness (IMT), flow-mediated dilation (FMD), and resting blood flow (BF(rest)) were measured using high-frequency ultrasonography. Arterial adaptations were investigated in the superficial femoral artery (SFA), the brachial artery (BA), and the carotid artery (CA). Mean SFA resting diameter was decreased from 6.57 mm (SD = 0.74 mm) at baseline to 5.77 mm (SD = 0.87 mm) at the end of the intervention (P muscular contractions for arterial diameter adaptations. Moreover, we propose that FMD and wall-to-lumen ratio are unaffected by ambulating with the HEPHAISTOS orthosis, which is suggestive of habitual acceleration profiles in the lower leg constituting an important stimulus for the maintenance of FMD and wall-to-lumen ratio.

  8. Hemodynamic Instability after Low-Energy Thigh Contusion Caused by Injury to the Femoral Artery: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Juan Miguel Rodríguez-Roiz

    2016-01-01

    Full Text Available Acute vascular injuries have been described in relation to high-energy trauma accidents or in patients undergoing surgery in the femoral area. We describe a healthy patient who sustained a direct, low-energy contusion in the thigh and presented haemodynamic instability. Arteriography was used to locate the point of bleeding, and embolisation and vessel occlusion were carried out to stop the haemorrhage. The genetic study identified the COL3A1 gene mutation; accordingly, the patient was diagnosed with the Ehlers-Danlos syndrome type IV (vascular type.

  9. Surgical treatment of non-traumatic aneurysm in ilio-femoral arterial region%髂股动脉区域非创伤性动脉瘤患者的外科治疗

    Institute of Scientific and Technical Information of China (English)

    张晶虹; 胡海地; 常青; 冯勇; 段志泉; 辛世杰

    2011-01-01

    目的 探讨髂股动脉区域非创伤性动脉瘤的诊治经验.方法 回顾性分析中国医科大学附属第一医院1985年1月至2010年11月61例髂股动脉区域非创伤性动脉瘤患者的临床资料.结果 本组髂动脉瘤29例,股动脉瘤32例,共有髂股动脉区域动脉瘤76个,其中43个髂动脉瘤和33个股动脉瘤;17例(27.9%)为多发性动脉瘤,8例(13.1%)发生髂动脉瘤或股动脉瘤破裂,4例(6.6%)合并动脉硬化闭塞症.本组中50例择期行动脉瘤切除、人工血管或自体血管移植;7例破裂性动脉瘤急诊行动脉瘤切除、血运重建术,另1例抢救无效死亡;1例髂动脉瘤行腔内修复和1例髂内动脉瘤行栓塞术;1例髂动脉瘤保守治疗.1例股动脉瘤术后因急性动脉血栓形成导致下肢缺血、坏死而截肢,其余未发生围手术期下肢及盆腔脏器缺血等并发症.随访期间7例死亡,存活患者移植血管通畅,无新生动脉瘤形成.结论 髂股动脉区域的非创伤性动脉瘤重在早期诊断和治疗,并注意多发性动脉瘤.动脉瘤切除及血运重建可获得良好疗效,术后应长期随访,观察有否新生动脉瘤.%Objective To summarize the surgical experiences of treating 61 cases of non-traumatic aneurysms in ilio-femoral arterial region.Methods The clinical data of 61 consecutive patients with nontraumatic aneurysms in ilio-femoral arterial region between January 1985 and November 2010 were retrospectively reviewed.Results There were a total of 76 non-traumatic aneurysms in ilio-femoral arterial region,including solitary iliac aneurysms ( n =29) and femoral aneurysms ( n =32).Seventeen (27.9%)patients had multiple aneurysms,8 ( 13.1% ) patients ruptured aneurysms and 4 ( 6.6% ) patients coexistent peripheral vascular occlusive disease.Fifty patients underwent electively aneurysm excision and graft (or autogenous vein ) replacement.Seven patients with ruptured aneurysms received emergency treatment.And one

  10. Observation of the curative effect immediate technique of the catheterization of the superficial temporal artery for retrograde intra-artery chemotherapy on postoperative chemotherapy administration in patients with oral squamous cell carcinomas%即刻行颞浅动脉逆行置管化疗技术对口腔鳞癌患者术后化疗的疗效观察

    Institute of Scientific and Technical Information of China (English)

    倪鑫; 赵洪伟; 冯驰; 季平; 邱丽华; 李勇; 高翔; 刘平; 王涛

    2015-01-01

    目的:对口腔鳞癌患者采用不同化疗给药途径并观察奈达铂(nedaplatin,NDP)和5‐氟尿嘧啶(5‐fluorouracil,5‐Fu)的疗效和不良反应。方法将64例口腔鳞癌患者分为术后普通静脉化疗组(IV组,32例)和术中即刻行颞浅动脉逆行置管化疗组(IA组,32例),两组化疗方案都为DNP和5‐Fu,其中IA组剂量为IV组的1/3,观察疗效和不良反应。结果IA组疗效优于IV组(P<0.05),同时IA组在骨髓抑制、胃肠道反应及口腔黏膜炎等化疗后并发症较IV组轻,差异有统计学意义(P<0.05)。结论术中IA疗效明显,不良反应轻且安全,适合临床推广。%Objective Treat patients with oral squamous cell carcinomas with different chemotherapy administration route ,and observe the effects and adverse reaction of Nedaplatin (NDP) and 5‐Fluorouracil (5‐Fu) .Methods Sixty four patients with oral squamous cell carcinomas were randomly divided into two groups which included intravenous chemotherapy group (IV)(with 32 ca‐ses) and intra‐artery infusion via the superficial temporal artery group (IA)(with 32 cases) .Each group was treated with NDP and 5‐Fu .The dose of the IA group was one third of that of the IV group .Efficacy and side effect had been observed .Results Efficacy of the IA group was better than that of the IV group (P<0 .05) .Complications including bone marrow suppression ,gastrointestinal reactions and oral mucositis of the IA group was lighter than that of the IV group ,which was significantly different (P<0 .05) . Conclusion The retrograde intra‐arterial chemotherapy via the superficial temporal artery during the surgery is safe ,effective and useful ,and it is worth of further clinical application .

  11. Falso Aneurisma Femoral Iatrogénico: Ainda uma indicação para a Cirurgia Convencional? Iatrogenic femoral pseudoaneurysm: still an indication for conventional surgery?

    Directory of Open Access Journals (Sweden)

    Nelson Oliveira

    2011-12-01

    report. Case Report: Sixty-one year old Caucasian male, with personal history of Hypertension, previous myocardial infarct, dilated myocardiopathy, paroxistic auricular fibrillation, with an implanted cardiodefibrillator, was submitted to His Bundle ablation by right femoral catheterization. He was referred because of the presence of a painful pulsating mass at the catheterization site. A color-Doppler confirmed the diagnosis of Pseudoaneurysm of the right Deep Femoral Artery with 3cm of diameter and the presence of an Arteriovenous Fistula between the superficial femoral vessels. The patient was treated in a Classic fashion, with exclusion of the pseudoaneurysm and repair of the superficial artery and vein. Conclusion: First-line treatment for PAN remains non-invasive but Open Surgical repair is still an important alternative in the management of a restrict group of patients.

  12. Ca(2+) sensitisation of force production by noradrenaline in femoral conductance and resistance arteries from rats with postinfarction congestive heart failure

    DEFF Research Database (Denmark)

    Trautner, Simon; Amtorp, Ole; Boesgaard, Soren

    2006-01-01

    In this study we tested the hypothesis that arterial myofilament Ca(2+) sensitivity and/or the Ca(2+) sensitising effect of noradrenaline (NA) is enhanced in post-infarction congestive heart failure (CHF), which could contribute to the high peripheral vascular resistance in this condition. Femora...

  13. Clinical application of free KISS lateral femoral circumflex artery perforator flap in repairing defects of limbs%游离旋股外侧动脉穿支KISS皮瓣修复四肢创面的临床应用

    Institute of Scientific and Technical Information of China (English)

    唐修俊; 魏在荣; 王波; 王达利; 孙广峰; 金文虎; 李海

    2015-01-01

    Objective To summarize the clinical efficacy of free KISS lateral femoral circumflex artery perforator flap in repairing defects of limbs.Methods Twelve cases were suffered wound surface defects on hands and feet.And the defects were repaired by flap construction from October,2010 to May,2013,based on the characteristics of the defects combined with anatomical features of the free lateral femoral circumflex artery perforator flap.Length of flap was adopted as the width for direct suture in the flap donor.Results Postoperative flap and donor area preliminarily healed.There was no vascular crisis.Twelve cases received 6-18 months followed-up (averaged of 12 months).The skin flap was good in color and texture.The dorsal flap was a bit bloated.Linear scar was remained in distal flap donor area.The quadriceps muscle power level 5,knee flexion,extension 10°-180°.Quadriceps strength,knee flexion and stretch activities were all normal.The flaps recovered protective sense.Four cases had tendon adhesion after hand tendon transplantation.The finger function was well recovered after release.At the last followup,the functions of the upper limbs were evaluated according to the trial evaluation standard of the Hand Surgery Association of Chinese Medical Association:6 cases were excellent,1 case was good,and 1 case was qualified.Conclusion The design of the lobulated tissue flap of the lateral femoral circumflex artery descending branch is flexible.Large area of the surface defect can be repaired.The flap donor area is directly sutured.It is an ideal method to repair the wound tissue defect.%目的 总结游离旋股外侧动脉穿支KISS皮瓣在修复四肢创面中的临床疗效. 方法 2010年10月-2013年5月,根据手足部创面的特点,结合旋股外侧动脉穿支解剖特点设计分叶皮瓣,通过皮瓣重组(KISS)修复手足部创面缺损12例,将皮瓣的长度变成宽度使皮瓣供区直接缝合. 结果 术后皮瓣及供区Ⅰ

  14. 等长收缩负荷对家兔股动脉固有侧支循环开放的影响%The effect of isometric contraction in opening femoral artery collateral circulation in rabbits

    Institute of Scientific and Technical Information of China (English)

    韩良; 励建安; 余滨宾

    2010-01-01

    Objective To explore the effect of isometric contraction-induced ischemic burden for evoking maximal intrinsic femoral artery collateral circulation. Methods Twenty-four adult New Zealand rabbits weighing (2.0±0.5) kg were subjected to a model of isometric contraction-induced ischemia. An electrode was implanted in the sciatic nerve of the left hind limb for evoking isometric contraction of the gastrocnemius, which blocked local blood flow and induced local ischemia. Femoral artery collateral blood flow (FCBF) was measured using a micro-sphere technique. Results Local blood flow was the lowest at 40% of the maximal isometric contraction (IEmax), and reached plateau at 60% of IEmax. FCBF increased gradually and reached a plateau at 40% of IEmax in the 4th min. After 4 minutes at 40% of IEmax, FCBF had increased to higher than pre-stimulus, peaking in the 2nd minute, and then decreasing gradually to baseline at the 5th minute after reperfusion. It ceased to increase when reperfusion was prolonged to 8 or 10 min. Conclusions The minimal ischemic burden for full obstruction of the femoral artery is 40% of IEmax, and the shortest stimulus duration is 4 min. The maximal FCBF opening duration is no more than 5 min.%目的 观察不同等长收缩负荷对股动脉同有侧支循环开放的影响,为研究生理性缺血训练对侧支循环生成的影响奠定基础.方法 选择健康成年家兔24只,体重(2.0±0.5)kg,于左下肢坐骨神经植入电极,电刺激产生等长收缩造成缺血,预先设定不同收缩强度和时间.实验终止时取坐骨神经支配区-腓肠肌组织,微球技术定量检测股动脉固有侧支血流(FCBF).结果 ①采用40%最大等长收缩强度(IEmax)时缺血区局部血流降低程度最大(P<0.01);采用60%IEmax和80%IEmax的局部血流下降率相比,差异无统计学意义.②采用40%IEmax刺激0~4 min,FCBF呈增加趋势,第4分钟时达峰值,较刺激即刻、刺激后第2,3分钟明显增加(P<0.01),至第5

  15. Bypass grafting with vascular prosthesis for treatment of infected femoral artery pseudoaneurysm%人工血管旁路移植治疗感染性股动脉假性动脉瘤

    Institute of Scientific and Technical Information of China (English)

    武国; 陈开; 郑江华; 戴毅

    2011-01-01

    目的 探讨人工血管旁路移植术治疗感染性股动脉假性动脉瘤的效果.方法 回顾性分析2005年1月-2010年12月40例感染性股动脉假性动脉瘤的临床资料,40例患者均为吸毒者,均接受了假性动脉瘤切除、彻底清创及人工血管旁路移植术.结果 围手术期内无死亡患者,且均保肢成功,创口均二期愈合.34例(85.0%)术后获得随访3 ~12个月,平均7.4个月.随访期内发生移植物感染3例(8.8%),取出感染的移植物后2例保肢成功,1例最终因肢体缺血坏死而接受截肢术;彩超检查发现人工血管腔内部分血栓形成4例(11.8%),给予抗血小板治疗,远端肢体均无缺血坏死.结论 人工血管旁路移植术是治疗注射吸毒所致感染性股动脉假性动脉瘤的安全、有效的方法.%Objective To evaluate the effect of the treatment of infected femoral artery pseudoaneurysm using bypass grafting with vascular prosthesis. Methods The clinical data of 40 patients with infected femoral artery pseudoaneurysm admitted to our hospital from January 2005 to December 2010 were analyzed retrospectively. All the 40 patients were drug abusers, and underwent pseudoaneurysm excision, radical debridement and vascular prosthesis bypass grafting operation. Results No death occurred and the patients' limbs were all successfully salvaged during the perioperative period. All wounds were healed by secondary intervention. Thirty-four patients were followed up for 3 to 12 months ( average of 7. 4 months ). Prosthetic graft infection occurred in three patients (8.8%) during the follow-up period, two of whom had their limbs salvaged after removal of the infected graft, and one finally underwent amputation because of ischemic limb necrosis. Thrombus formation was detected by color Doppler ultrasound in some parts of the lumen of prosthetic graft in four patients (11.8%), however, no ischemic necrosis occurred in the affected limbs of the four patients after

  16. First Clinical Investigations of New Ultrasound Techniques in Three Patient Groups: Patients with Liver Tumors, Arteriovenous Fistulas, and Arteriosclerotic Femoral Arteries

    DEFF Research Database (Denmark)

    Hansen, Peter Møller

    ultrasound images of very high quality with high frame rate. Synthetic aperture is unfortunately very demanding computationally, and is therefore used only in experimental scanners. SASB reduces the data volume by a factor of 64, thereby making it possible to implement the technology on a commercial...... ultrasound scanner, to perform wireless data transfer and in the future to develop e.g. a wireless ultrasonic transducer. Nineteen patients with either primary liver cancer or liver metastases from colon cancer were ultrasound scanned the day before planned liver resection. Patients were scanned...... of the significant data reduction, is suitable for clinical use. In Study II, 20 patients with arteriovenous fistulas for hemodialysis were ultrasound scanned directly on the most superficial and accessible part of the fistula. The vector ultrasound technique Vector Flow Imaging (VFI) was used. VFI can...

  17. Intraoperative arteriography during femoral-popliteal bypass.

    Science.gov (United States)

    Liddicoat, J E; Bekassy, S M; DeBakey, M E

    1975-07-01

    Minor technical errors may jeopardize the patency of femoral-popliteal bypass grafts. In an attempt to detect such errors, intraoperative arteriography has been routinely employed. It allows immediate recognition and correction of the most common abnormal findings: intraluminal debris, intimal dissection, distal thrombosis, arterial spasm, and kinking of the graft.

  18. Laser angioplasty of totally occluded arteries of the limb

    Science.gov (United States)

    Szopinski, Piotr; Hara, Marek; Noszczyk, Wojciech

    1996-03-01

    The authors summarize their experience in the use of Nd-YAG laser in chronic occlusion of lower limb arteries. Percutaneous transluminal laser angioplasty (PTLA) with laser-heated metal and sapphire tips were used as an adjuvant to conventional balloon angioplasty. In cases of reocclusions, endovascular stents were implanted. Laser recanalization was performed in 46 arteries (iliac, superficial femoral, and popliteal). Indications for the procedure were: limb salvage, claudication below 100 m, and temporal or rest pain. Initial clinical and hemodynamic improvement was observed in 37 (80%) patients. Four perforations occurred without clinical sequel. The one-year cumulative clinical patency was 27 (58%) of the 46 lesions. PTLA may be appropriate for high-risk patients, who are unsuitable for surgical reconstruction because of the concomitant diseases. The combination of laser recanalization and implantation of vascular stents may be a promising method in the management of limb ischemia.

  19. 三羟异黄酮对离体家兔股动脉张力的影响及其机制%Action of genistein on tension of isolated rabbit femoral artery and its mechanism

    Institute of Scientific and Technical Information of China (English)

    吉恩生; 李清; 何瑞荣

    2002-01-01

    The phytoestrogen genistein has been shown to relax agonist-preconstricted arteries in vitro, the mechanism of this relaxation remains incompletely understood. The present study aimed to investigate the effect of phytoestrogen genistein on the tension of rabbit femoral arteries in vitro and to determine the mechanism of such relaxation. The results are as follows: (1) genistein (10~40 μmol/L) relaxed femoral arterial rings in a concentration-dependent manner under the condition of precontraction induced by phenylephrine (PE, 1 μmol/L); (2) removal of the endothelium significantly inhibited genistein-induced relaxation; (3) pretreatment with NOS inhibitor NG-nitro-L-arginine methyl ester (L-NAME, 100 μmol/L) also significantly inhibited this relaxation by genistein, implying that the concentration-dependent vasorelaxation caused by genistein is endothelium-dependent and involved nitric oxide; and (4) pretreatment with an L-type calcium channel agonist, Bay K 8644 (0.5 μmol/L), also significantly inhibited the genistein-induced relaxation in both endothelium-intact and endothelium-denuded rings. The results suggest that the genistein-induced vascular relaxation of these rabbit arteries is partially endothelium-dependent and involves calcium antagonistic mechanism.%植物雌激素三羟异黄酮 (genistein, GST)使离体的预先收缩的动脉舒张, 其舒张的机制仍然不完全清楚.本研究旨在观察植物雌激素三羟异黄酮对离体家兔股动脉的作用及其机制.结果如下: (1) 在苯肾上腺素(PE, 1 μmol/L)引起血管收缩的基础上, GST (10~40 μmol/L) 剂量依赖性地舒张离体家兔股动脉; (2)去除血管内皮显著地抑制GST 引起的舒张; (3)在内皮完整情况下,预先应用NOS抑制剂L-NAME (100 μmol/L)也可显著地抑制GST引起的舒张, 提示GST的舒血管作用是内皮依赖的, 并与一氧化氮有关; (4)在内皮完整的和去除内皮的股动脉环, 预先应

  20. Deep vein and artery thrombosis associated with cetuximab-based chemoradiotherapy

    Directory of Open Access Journals (Sweden)

    Deepak Gupta

    2011-01-01

    Full Text Available Molecular targeted agents have lower hematological toxicity. However, specific side-effects such as allergic rashes, skin reactions and high cost limit their use. We report a case of 35-year-old male patient with carcinoma of left tonsil treated with concurrent cetuximab and radiotherapy. After four weeks of treatment, the patient developed sudden onset of pain in the left calf region radiating to the left foot. Doppler study of the left lower limb revealed complete thrombosis of superficial femoral, popliteal and proximal tibial arteries and veins and no flow in anterior tibial artery and lower posterior tibial artery. Emergency embolectomy was done. After 48 h of observation, no improvement was noted. A repeat Doppler examination showed similar finding. Ultimately a left lower limb amputation was done. We report simultaneous arterio-venous thrombosis associated with cetuximab-based chemoradiotherapy. Oncologists should be aware of this possible complication to undertake early intervention.

  1. [The use of a synthetic vascular artificial prosthesis or arterial homograft in cases of patients with the arteriosclerosis and terminal insufficiency of kidney cured by the kidney transplantation].

    Science.gov (United States)

    Pupka, Artur; Blocher, Dariusz; Staniszewski, Tomasz; Płonek, Tomasz; Bogdan, Justyna

    2009-01-01

    Arterial transplantations were practiced in the vascular surgery since the beginning of her formation but without successes in the distant observation. Transplantation of a kidney is a routine conduct in the treatment of the decadent incapacity of a kidney. The dissertation concerns a use of arterial allografts kept using a method of a cold ischaemia in the protective liquid or synthetic vascular dacron artificial limbs or PTFE used as arterial foot-bridges at patients with the atherosclerotic obstruction aortal-pelvic, treated with the kidney transplantation. The arterial transplant is created from the aorta, arteria iliacas common and externa, femoral arteries common and superficial. A tissue material is kept using the method of the cold ischaemia and practical as the aortal foot-bridge-femoral or aortal-two-femoral at classified earlier patients being subjecteds to transfusion. The other way of a transplantation of a kidney at patients with the arteriosclerosis is the realization earlier or one-temporarily the vascular foot-bridge with use of the synthetic artificial limb. It seems that vascular artificial limbs about enlarged resistance on the contagion should be used in such a case. Sonographic examinations with duplex doppler and angiography are performed in all cases. The analysis of such cures can make a creation of the most profitable algorithm of the conduct possible in cases of patients suffering from ischaemia of lower limbs and requiring a transplantation of a kidney because of its incapacity.

  2. Superficies de segundo orden

    OpenAIRE

    Salazar Salazar, Luis Álvaro

    1987-01-01

    Este trabajo se propone poner al alcance de estudiantes de primeros semestres de carreras de aplicación de la matemática, un algoritmo proporcionado por el álgebra lineal, para tratar con mas generalidad, agilidad y libertad unos objetos de la geometría analítica de no fácil manipulación por otros métodos y que se conocen como superficies de segundo orden o superficies cuádricas. En este orden de ideas, el autor considera importante que con este tratamiento se incluya este tema en una asignat...

  3. First Clinical Investigations of New Ultrasound Techniques in Three Patient Groups: Patients with Liver Tumors, Arteriovenous Fistulas, and Arteriosclerotic Femoral Arteries

    DEFF Research Database (Denmark)

    Hansen, Peter Møller

    arteriosclerotic lesion was raised, recordings of the flow were made. The recordings were subsequently analyzed, and for each recording blood flow velocity at the lesion was compared with the flow velocity in a healthy adjacent arterial segment. If the velocity at the lesion was higher than in the healthy segment...... of the new ultrasound techniques in selected groups of patients. For all three studies the results are promising, and hopefully the techniques will find their way into everyday clinical practice for the benefit of both patients and healthcare practitioners....

  4. Brachiomedian artery (arteria brachiomediana revisited: a comprehensive review

    Directory of Open Access Journals (Sweden)

    David Kachlik

    2016-03-01

    Full Text Available This article reviews in detail the superficial brachiomedian artery (arteria brachiomediana superficialis, a very rare variant of the main arterial trunks of the upper limb. It branches either from the axillary artery or the brachial artery, descends superficially in the arm (similar to the course of the superficial brachial artery and continues across the cubital fossa, runs superficially in the forearm, approaches the median nerve and enters the carpal canal to reach the hand. It usually terminates in the superficial palmar arch. The first drawing was published, in 1830, and the first description was published, in 1844. Altogether, to our knowledge, only 31 cases of a true, superficial brachiomedian artery have been reported (Some cases are incorrectly reported as superficial brachioradiomedian artery or superficial brachioulnomedian artery. Based on a meta-analysis of known, available studies, the incidence is 0.23% in Caucasians and 1.48% in Mongolians. Knowing whether or not this arterial variant is present is important in clinical medicine and relevant for: The catheterization via the radial or ulnar artery; harvesting the vascular pedicle for a forearm flap based on the radial, ulnar or superficial brachiomedian arteries; the possible collateral circulation in cases of the arterial closure; and the surgical management of carpal tunnel syndrome. Its presence can elevate the danger of an injury to the superficially located variant artery or of an accidental injection.

  5. Osteosynthesis of ununited femoral neck fracture by internal fixation combined with iliac crest bone chips and muscle pedicle bone grafting

    Directory of Open Access Journals (Sweden)

    D D Baksi

    2016-01-01

    Full Text Available Background: Ununited femoral neck fracture is seen commonly in developing countries due to delayed presentation or failure of primary internal fixation. Such fractures, commonly present with partial or total absorption of femoral neck, osteonecrosis of femoral head in 8-30% cases with upward migration of trochanter posing problem for osteosynthesis, especially in younger individuals. Several techniques for treatment of such conditions are described like osteotomies or nonvascularied cortical or cancellous bone grafting provided varying degrees of success in terms of fracture union but unsatisfactory long term results occurred due to varying incidence of avascular necrosis (AVN of femoral head. Moreover, in presence of AVN of femoral head neither free fibular graft nor cancellous bone graft is satisfactory. The vascularied bone grafting by deep circumflex iliac artery based on iliac crest bone grafting, free vascularied fibular grafting and muscle pedicle periosteal grafting showed high incidence of success rate. Osteosynthesis is the preferred treatment of choice in ununited femoral neck fracture in younger individuals. Materials and Methods: Of the 293 patients operated during the period from June 1977 to June 2009, 42 were lost to followup. Seven patients with gluteus medius muscle pedicle bone grafting (MPBG were excluded. Thus, out of 244 patients, 208 (85.3% untreated nonunion and 36 (14.7% following failure of primary internal fixation were available for studies. Time interval between the date of injury and operation in untreated nonunion cases was mean 6.5 months and in failed internal fixation cases was mean 11.2 months. Ages of the patients varied from 16 to 55 years. Seventy patients had partial and 174 had subtotal absorption of the femoral neck. Evidence of avascular necrosis (AVN femoral head was found histologically in 135 (54.3% and radiologically in 48 (19.7% patients. The patients were operated by open reduction of fracture

  6. Patient-specific structural effects on hemodynamics in the ischemic lower limb artery

    Science.gov (United States)

    Xu, Pengcheng; Liu, Xin; Song, Qi; Chen, Guishan; Wang, Defeng; Zhang, Heye; Yan, Li; Liu, Dan; Huang, Wenhua

    2016-12-01

    Lower limb peripheral artery disease is a prevalent chronic non-communicable disease without obvious symptoms. However, the effect of ischemic lower limb peripheral arteries on hemodynamics remains unclear. In this study, we investigated the variation of the hemodynamics caused by patient-specific structural artery characteristics. Computational fluid dynamic simulations were performed on seven lower limb (including superficial femoral, deep femoral and popliteal) artery models that were reconstructed from magnetic resonance imaging. We found that increased wall shear stress (WSS) was mainly caused by the increasing severity of stenosis, bending, and branching. Our results showed that the increase in the WSS value at a stenosis at the bifurcation was 2.7 Pa. In contrast, the isolated stenosis and branch caused a WSS increase of 0.7 Pa and 0.5 Pa, respectively. The WSS in the narrow popliteal artery was more sensitive to a reduction in radius. Our results also demonstrate that the distribution of the velocity and pressure gradient are highly structurally related. At last, Ultrasound Doppler velocimeter measured result was presented as a validation. In conclusion, the distribution of hemodynamics may serve as a supplement for clinical decision-making to prevent the occurrence of a morbid or mortal ischemic event.

  7. Subintimal angioplasty treat superficial femoral artery occlusions%内膜下血管成形术治疗下肢股浅动脉硬化闭塞症

    Institute of Scientific and Technical Information of China (English)

    王育强

    2008-01-01

    目的 探讨内膜下血管成形术(SIA)治疗下肢股浅动脉硬化闭塞症的安全性和有效性.方法 采用内膜下血管成形术(SIA)治疗下肢股浅动脉硬化闭塞症32例(36条肢体).结果 手术均成功,术后踝肱指数(ABI)平均提高0.35,术后临床症状均有明显改善,SIA术后6个月,治疗动脉的通畅率为86.11%.结论 SIA用于治疗下肢股浅动脉硬化闭塞症安全,有效.

  8. Recanalization of a Heavily Calcified Chronic Total Occlusion in a Femoropopliteal Artery Using a Wingman Crossing Catheter

    Science.gov (United States)

    Inoue, Naoto; Tanaka, Akiko

    2016-01-01

    We present a 77-year-old female with heavily calcified chronic total occlusions (CTO) in a superficial femoral artery treated by endovascular therapy using a Wingman crossing catheter, which is an over-the-wire catheter with a metallic blade, controlled manually. The blade could probe and track the calcified cap of CTO, wherein any hydrophilic guidewires or looped wires could not penetrate. Moreover, the Wingman could proceed through the occlusion and introduce a guidewire into distal intramedial lumen as a support catheter. Finally, wire crossing was achieved using a bi-directional approach. The Wingman can be a simple solution for crossing calcified peripheral CTO. PMID:27375810

  9. Femoral bowing plane adaptation to femoral anteversion

    Directory of Open Access Journals (Sweden)

    Alp Akman

    2017-01-01

    Full Text Available Background: Femoral bowing plane (FBP is the unattended subject in the literature. More over the femoral shaft with its bowing is neglected in established anteversion determination methods. There is limited information about the relationship between FBP and anteversion. Thus we focused on this subject and hypothesized that there could be an adaptation of FBP to anteversion. Materials and Methods: FBP is determined on three-dimensional solid models derived from the left femoral computerized tomography data of 47 patients which were taken before for another reason and comparatively evaluated with anteversion. There were 20 women and 27 men. The mean age of patients was 56 years (range 21-84 years. Results: The anteversion values were found as the angle between a distal condylar axis (DCA and femoral neck anteversion axis (FNAA along an imaginary longitudinal femoral axis (LFA in the true cranio-caudal view. The FBP was determined as a plane that passes through the centre-points of three pre-determinated sections on the femoral shaft. The angles between DCA, FNAA and FBP were comparatively evaluated. The independent samples t-test was used for statistical analysis. At the end, it was found that FBP lies nearly perpendicular to the anteversion axis for the mean of our sample which is around 89° in females and 93° in males (range 78-102°. On the other hand, FBP does not lie close to the sagittal femoral plane (SFP; instead, there is an average 12.5° external rotation relative to the SFP. FBP is correlated well with anteversion in terms of FBP inclination from SFP and femoral torsion (i.e., angle between FBP and femoral neck anteversion axis (P0 < 0.001; r = 0.680 and r = −0.682, respectively. Combined correlation is perfect (R[2] = 1 as the FBP, SFP, and posterior femoral plane forms a triangle in the cranio-caudal view. Conclusions: We found that FBP adapts to anteversion. As FBP lies close to perpendicularity for the mean, femoral component

  10. Femoral bowing plane adaptation to femoral anteversion

    Science.gov (United States)

    Akman, Alp; Demirkan, Fahir; Sabir, Nuran; Oto, Murat; Yorukoglu, Cagdas; Kiter, Esat

    2017-01-01

    Background: Femoral bowing plane (FBP) is the unattended subject in the literature. More over the femoral shaft with its bowing is neglected in established anteversion determination methods. There is limited information about the relationship between FBP and anteversion. Thus we focused on this subject and hypothesized that there could be an adaptation of FBP to anteversion. Materials and Methods: FBP is determined on three-dimensional solid models derived from the left femoral computerized tomography data of 47 patients which were taken before for another reason and comparatively evaluated with anteversion. There were 20 women and 27 men. The mean age of patients was 56 years (range 21–84 years). Results: The anteversion values were found as the angle between a distal condylar axis (DCA) and femoral neck anteversion axis (FNAA) along an imaginary longitudinal femoral axis (LFA) in the true cranio-caudal view. The FBP was determined as a plane that passes through the centre-points of three pre-determinated sections on the femoral shaft. The angles between DCA, FNAA and FBP were comparatively evaluated. The independent samples t-test was used for statistical analysis. At the end, it was found that FBP lies nearly perpendicular to the anteversion axis for the mean of our sample which is around 89° in females and 93° in males (range 78–102°). On the other hand, FBP does not lie close to the sagittal femoral plane (SFP); instead, there is an average 12.5° external rotation relative to the SFP. FBP is correlated well with anteversion in terms of FBP inclination from SFP and femoral torsion (i.e., angle between FBP and femoral neck anteversion axis (P < 0.001; r = 0.680 and r = −0.682, respectively). Combined correlation is perfect (R2 = 1) as the FBP, SFP, and posterior femoral plane forms a triangle in the cranio-caudal view. Conclusions: We found that FBP adapts to anteversion. As FBP lies close to perpendicularity for the mean, femoral component positioning

  11. Femoral hernia causing pneumoperitoneum.

    OpenAIRE

    King, H. A.; Boulter, P. S.

    1986-01-01

    Richter's hernia, in which only a portion of the circumference of the intestine lies within the sac, is a common complication of femoral hernia. This case report is of 39 year old female who presented with a pneumoperitoneum and was found at laparotomy to have a right femoral Richter's hernia containing a knuckle of perforated small bowel. This is a previously unreported presentation of femoral hernia.

  12. Femoral hernia repair

    Science.gov (United States)

    Femorocele repair; Herniorrhaphy; Hernioplasty - femoral ... During surgery to repair the hernia, the bulging tissue is pushed back in. The weakened area is sewn closed or strengthened. This repair ...

  13. Common Superficial Bursitis.

    Science.gov (United States)

    Khodaee, Morteza

    2017-02-15

    Superficial bursitis most often occurs in the olecranon and prepatellar bursae. Less common locations are the superficial infrapatellar and subcutaneous (superficial) calcaneal bursae. Chronic microtrauma (e.g., kneeling on the prepatellar bursa) is the most common cause of superficial bursitis. Other causes include acute trauma/hemorrhage, inflammatory disorders such as gout or rheumatoid arthritis, and infection (septic bursitis). Diagnosis is usually based on clinical presentation, with a particular focus on signs of septic bursitis. Ultrasonography can help distinguish bursitis from cellulitis. Blood testing (white blood cell count, inflammatory markers) and magnetic resonance imaging can help distinguish infectious from noninfectious causes. If infection is suspected, bursal aspiration should be performed and fluid examined using Gram stain, crystal analysis, glucose measurement, blood cell count, and culture. Management depends on the type of bursitis. Acute traumatic/hemorrhagic bursitis is treated conservatively with ice, elevation, rest, and analgesics; aspiration may shorten the duration of symptoms. Chronic microtraumatic bursitis should be treated conservatively, and the underlying cause addressed. Bursal aspiration of microtraumatic bursitis is generally not recommended because of the risk of iatrogenic septic bursitis. Although intrabursal corticosteroid injections are sometimes used to treat microtraumatic bursitis, high-quality evidence demonstrating any benefit is unavailable. Chronic inflammatory bursitis (e.g., gout, rheumatoid arthritis) is treated by addressing the underlying condition, and intrabursal corticosteroid injections are often used. For septic bursitis, antibiotics effective against Staphylococcus aureus are generally the initial treatment, with surgery reserved for bursitis not responsive to antibiotics or for recurrent cases. Outpatient antibiotics may be considered in those who are not acutely ill; patients who are acutely ill

  14. SUPERFICIAL CERVICAL PLEXUS BLOCK

    Directory of Open Access Journals (Sweden)

    Komang Mega Puspadisari

    2014-01-01

    Full Text Available Superficial cervical plexus block is one of the regional anesthesia in  neck were limited to thesuperficial fascia. Anesthesia is used to relieve pain caused either during or after the surgery iscompleted. This technique can be done by landmark or with ultrasound guiding. The midpointof posterior border of the Sternocleidomastoid was identified and the prosedure done on thatplace or on the level of cartilage cricoid.

  15. Three-dimensional bending, torsion and axial compression of the femoropopliteal artery during limb flexion.

    Science.gov (United States)

    MacTaggart, Jason N; Phillips, Nicholas Y; Lomneth, Carol S; Pipinos, Iraklis I; Bowen, Robert; Baxter, B Timothy; Johanning, Jason; Longo, G Matthew; Desyatova, Anastasia S; Moulton, Michael J; Dzenis, Yuris A; Kamenskiy, Alexey V

    2014-07-18

    High failure rates of femoropopliteal artery reconstruction are commonly attributed to complex 3D arterial deformations that occur with limb movement. The purpose of this study was to develop a method for accurate assessment of these deformations. Custom-made stainless-steel markers were deployed into 5 in situ cadaveric femoropopliteal arteries using fluoroscopy. Thin-section CT images were acquired with each limb in the straight and acutely bent states. Image segmentation and 3D reconstruction allowed comparison of the relative locations of each intra-arterial marker position for determination of the artery's bending, torsion and axial compression. After imaging, each artery was excised for histological analysis using Verhoeff-Van Gieson staining. Femoropopliteal arteries deformed non-uniformly with highly localized deformations in the proximal superficial femoral artery, and between the adductor hiatus and distal popliteal artery. The largest bending (11±3-6±1 mm radius of curvature), twisting (28±9-77±27°/cm) and axial compression (19±10-30±8%) were registered at the adductor hiatus and the below knee popliteal artery. These deformations were 3.7, 19 and 2.5 fold more severe than values currently reported in the literature. Histology demonstrated a distinct sub-adventitial layer of longitudinally oriented elastin fibers with intimal thickening in the segments with the largest deformations. This endovascular intra-arterial marker technique can quantify the non-uniform 3D deformations of the femoropopliteal artery during knee flexion without disturbing surrounding structures. We demonstrate that 3D arterial bending, torsion and compression in the flexed lower limb are highly localized and are substantially more severe than previously reported.

  16. Variation in the Branching Pattern of the Superficial Palmar Arch

    Directory of Open Access Journals (Sweden)

    Sumalatha S

    2016-05-01

    Full Text Available In this article we describe a rare variation in the superficial palmar arch (SPA encountered during routine cadaveric dissection. SPA was formed by the superficial branches of ulnar and radial arteries which provided a proper digital branch to the ulnar side of the little finger and three common palmar digital branches to the medial four digits. Additionally a first common digital artery was seen to emerge from the radial side of SPA which further divided into the arteria princeps pollicis and arteria radialis indicis. We also found a small communicating branch between the arteria princeps pollicis and the radial artery in the anatomical snuff box. Such arterial variations in the palm due to alteration in the developmental sequence remains a crucial issue in the reconstructive hand surgeries, especially while dealing with the innovative microsurgical procedures, where these varied patterns act as pivotal points around which successful results of various advanced surgical procedures revolve.

  17. The effect of sumatriptan on cephalic arteries

    DEFF Research Database (Denmark)

    Amin, Faisal Mohammad; Asghar, Mohammad Sohail; Ravneberg, Julie W;

    2013-01-01

    AIM: To explore a possible differential effect of sumatriptan on extracerebral versus cerebral arteries, we examined the superficial temporal (STA), middle meningeal (MMA), extracranial internal carotid (ICAextra), intracranial internal carotid (ICAintra), middle cerebral (MCA) and basilar arteries...

  18. Study of the anatomical position of the femoral nerve by magnetic resonance imaging in patients with fractured neck of femur: relevance to femoral nerve block.

    LENUS (Irish Health Repository)

    Mehmood, Shehzad

    2012-01-31

    STUDY OBJECTIVE: To determine the anatomical location of the femoral nerve in patients who have sustained fracture of the neck of femur, and its relevance to femoral nerve block technique. DESIGN: Prospective, observational clinical study. SETTING: Orthopedic and Radiology departments of a regional hospital. SUBJECTS: 10 consecutive adult ASA physical status II and III patients (mean age, 78.5 yrs) and 4 adult healthy volunteers. INTERVENTIONS: A T1 magnetic resonance imaging scan was performed of both upper thighs in patients and healthy volunteers successfully. MEASUREMENTS: The distance (mm) between the midpoint of the femoral artery and the midpoint of the femoral nerve, and the distance of the femoral nerve from the skin was measured at the mid-inguinal ligament, the pubic tubercle, and at the mid-inguinal crease. Data are shown as means (SD). Differences between both sides were compared using paired Student\\'s t-tests. P < 0.05 was significant. MAIN RESULTS: In patients the mean distance (mm) between the midpoint of the femoral nerve from the midpoint of femoral artery at the mid-inguinal crease on the fractured and non-fractured sides was 10.7 and 11.0, respectively (P = 0.87). The mean distance (mm) between the midpoint of the femoral nerve from the midpoint of the femoral artery at the mid-inguinal ligament on the fractured and non-fractured sides was 9.64 and 12.5, respectively (P = 0.03). The mean distance (mm) between the midpoint of the femoral nerve from the midpoint of the femoral artery at the pubic tubercle on the fractured and non-fractured sides was 8.74 and 10.49, respectively (P = 0.18). CONCLUSIONS: Blockade of the femoral nerve may be easier to perform at the mid-inguinal crease in patients with fractured neck of femur.

  19. 髂外-腘动脉人工血管交叉转流术治疗髂股动脉硬化闭塞症%External iliac-popliteal artery artificial graft cross bypass for the treatment of arterial occlusion in lilac-femoral arteriosclerosis

    Institute of Scientific and Technical Information of China (English)

    马杰; 马韬

    2009-01-01

    Objective To study the curative effectiveness of external iliac-popliteal artery artificial graft cross bypass in treating extensive arterial occlusion in unilateral lilac-femoral arteriosclerosis. Methods From Sep. 1999 to Oct. 2007, 39 elder patients were diagnosed as having extensive arterial occlusion in unilateral lilac-femoral arteriosclerosis by color Doppler ultrasonography, CTA or DSA. 25 patients (61.5%) had resting pain, 14 had ulcers or gangrenes in the toes. The average ankle-brachial index was 0. 19. Contralateral external iliac-popliteal artery artificial graft cross bypass surgeries were performed on 22 patients from left to right, the other 17 were from right to left. Results There were no perioperative death or amputation. The ankle-brachial index increased from 0 ~ 0. 41 ( preoperative ) to 0. 85 ~ 1.02(postoperative) ; the claudication distance increased from 15 ~ 60 m (preoperative) to 350 ~ 500 m or more than 500 m [ postoperatively at the speed of (100 ~ 120) m/min] ; The postoperative color Doppler uhrasonography showed the average velocity of the popliteal artery was 45 cm/s. In the anterior tibial artery or the posterior tibial artery, little blood flow was showed in preoperative color Doppler ultrasonography examination, the postoperative average blood flow velocity was 41 cm/s. 35 patients (89. 7% ) were followed up for an average of 3.4 years, with an accumulative patency rate of 85.7%. Four patients had amputation, the limb salvage rate is 88.6%. Conclusion External iliac-popliteal artery artificial graft cross bypass is effective in treating unilateral lilac-femoral arterial occlusion, particularly for aged patients with vital organ incompetence.%目的 探讨髂外动脉-腘动脉人工血管移植交义转流术治疗单侧髂股动脉硬化广泛性闭塞的疗效.方法 1999年9月至2007年10月39例患者经血管彩超、CT血管造影(CTA)或数字减影血管造影(DSA)检查,证实单侧髂股动脉

  20. Superficies de placer

    OpenAIRE

    Delli Gatti, Romina

    2012-01-01

    La presente tesis cuenta con 28 pinturas en distintos formatos y tama- ños a través de los cuales la artista investiga diferentes objetos de su entorno cotidiano que le resultan agradables y pueden llegar a transformar anímicamente. De esta manera se van construyendo superficies ideales, relacionadas principalmente con lo cotidiano y lo intimo, lo orgánico, lo industrial, el diseño textil y lo abstracto. Es un intento por generar o prolongar una sensación visual de agrado y placer a tra...

  1. 血管内介入改良Seldinger技术股动脉 指间定位法的研究与临床应用%The Clinical Research and Application of Femoral Artery Inter-finger Location for Intravascular Modified Seldinger's Technique

    Institute of Scientific and Technical Information of China (English)

    崔新建; 王兆欣; 陈保伦; 杨东升; 沈其杰

    2001-01-01

    目的 为提高Seldinger股动脉穿刺技术的成功率,降低并发症,使得血管内介入放射新技术在临床顺利开展。 方法 在改良Seldinger技术的基础上,将其改进为股动脉指间定位法,即术者的左手食、中指平行于股动脉,将股动脉置于二指间中,扪其搏动定位。 结果 改良Seldinger技术股动脉指间定位法一针穿刺成功率为72%,明显高于传统的定位法(23%)。 结论 改良Seldinger技术股动脉指间定位法的应用,使一针穿刺成功率显著提高,血肿并发症降低,利于血管内介入诊断与治疗新技术的开展。%To improve success rate for femoral artery puncture with intravascular modified Seldinger's technique, and decrease its complications. Methods On base of modified Seldinger's technique, we devised a method of inter-finger location for femoral puncture, ie, the operator put his indicator and middle finger close and parallel to femeoral artery, felt artery pulsation and located it. Results The success and complication rate for inter-finger locations and traditional locations are 72%,23%, respectively. Conclusion Inter-finger location method based on modified Seldinger's technique can raise success rate for femoral puncture, decrease complication rate, such as hematomas, henefiting developement of intravascular interventional diagnosis and treatment.

  2. Radiographic femoral varus measurement is affected unpredictably by femoral rotation

    DEFF Research Database (Denmark)

    Miles, James Edward

    Radiographic measurements of femoral varus are used to determine if intervention to correct femoral deformity is required, and to calculate the required correction. The varus angle is defined as the angle between the proximal femoral long axis (PFLA) and an axis tangential to the distal femoral c...

  3. Femoral arteriographic finding in acute ergotism: Report of A Case

    Energy Technology Data Exchange (ETDEWEB)

    Rhee, H. S.; Lee, K. N.; Cha, S. B. [St. Mary' s Hospital, Catholic Medical College, Seoul (Korea, Republic of)

    1971-10-15

    A case of acute ergotism with angiographic demonstration of bilateral femoral artery involvement is reported. A 27-year-old married woman was admitted because of sudden onset of severe pain in both flanks and lower legs, followed by numbness and coldness of the skin on both legs. The attack occurred after the administration of ergot tartrate as postpartum care. Femoral arteriography was performed on 10th day of illness with the Seldinger technic. The femoral arteries were generally smaller in caliber than normal. There was no definite evidence of occlusive disease. Findings were more or less symmetrical and extended to lower legs where only fine branches were visualized. The final diagnosis was diffuse vasospasm due to acute ergotism with secondary occlusion of the arteries of lower leg bilaterally.

  4. Nitinol Stent Fatigue in a Peripheral Human Artery Subjected to Pulsatile and Articulation Loading

    Science.gov (United States)

    Harvey, Sean Michael

    2011-07-01

    Nitinol self-expanding stents are used to treat peripheral occluded vessels such as the superficial femoral artery or the carotid. The complex vessel articulation requires a stent device that is flexible and kink resistant yet durable. The present study shows how the latest advances in commercially available engineering software tools permit engineering simulations of the many aspects of the Nitinol stent design and analysis. Two stent geometries are evaluated: a helical type stent design, and a more traditional straight strut, with multiple crowns design. The fatigue performance of the two stents is compared. The results show that advanced nonlinear finite element simulations and fatigue predictions of the Nitinol stent are possible today inside realistic simulated human arteries. The finite element analysis software used in this study is SimXpert, Marc, and Mentat (MSC Software, Santa Ana, CA).

  5. Unusual bilateral origins of the deep artery of thigh and associated variations

    Directory of Open Access Journals (Sweden)

    Shankar N

    2009-08-01

    Full Text Available During routine dissection of a middle aged male cadaver, an unusual origin of the deep artery of thigh was observed bilaterally. It arose from the femoral artery less than 1 cm distal to the inguinal ligament. On both sides, its diameter was greater than that of the femoral artery. An unusually distal origin of the lateral circumflex femoral artery was observed bilaterally. An unnamed branch from the deep artery of thigh on the left side was seen coursing superolaterally towards the anterior superior iliac spine. The deep external pudendal artery arose from the medial circumflex femoral artery on either side. On the right side, the femoral nerve emerged in the femoral triangle by piercing the iliacus muscle. As the deep artery of thigh is often used in vascular reconstructive procedures and is frequently visualized by various radiological imaging techniques, anatomical variations of itself as well as its branches have significant clinical implications.

  6. Results of bypasses to the anterior tibial artery through the interosseous membrane.

    Science.gov (United States)

    Illuminati, G; Calio, F G; Bertagni, A; Martinelli, V

    1998-08-01

    The purpose of the present study was to retrospectively evaluate the results of anatomically tunneled grafts to the anterior tibial artery for distal revascularization in terms of patency and limb salvage rates as well as local morbidity, which can lengthen the postoperative hospital stay. Twenty-three patients received 24 bypasses to the anterior tibial artery, with grafts tunneled through the interosseous membrane. The mean age was 67 years; 10 patients were diabetic, 12 were smokers, 9 presented with significant coronary artery disease, and 2 with chronic renal insufficiency. The donor vessel was the common femoral artery in 17 cases, the superficial femoral artery in 4, and the infra-articular popliteal artery in 3. The graft material consisted in the reversed saphenous vein in 4 cases, the non-reversed devalvulated ex situ saphenous vein in 11, composite polytetrafluoroethylene (PTFE) + inversed saphenous vein in 6, and PTFE alone in 3 cases. No postoperative mortality was observed, nor was there postoperative graft occlusion or need for major amputation. The average postoperative length of stay in the hospital was 9.7 days. Two local surgical wound complications were observed, which did not necessitate a postoperative hospital stay exceeding 15 days. Cumulative primary patency and limb salvage rates at 3 years were 50% and 70%, respectively. Anatomic tunneling of grafts to the anterior tibial artery yields patency and limb salvage rates comparable to those reported in the literature for distal bypasses and, considered overall, an acceptably low local morbidity and short hospital stay. Definitive superiority over externally tunneled grafts, however, is not definitely demonstrated by this study and should be prospectively tested.

  7. Transradial artery coronary angioplasty.

    Science.gov (United States)

    Kiemeneij, F; Laarman, G J; de Melker, E

    1995-01-01

    This study explored the feasibility and safety of percutaneous coronary balloon angioplasty (PTCA) with miniaturized PTCA equipment via the radial artery. Coronary angioplasty (PTCA) via the femoral or brachial arteries may be associated with rare vascular complications such as bleeding and damage to the artery and adjacent structures. It was postulated that PTCA via the radial artery with miniaturized angioplasty equipment is feasible and that no major puncture site-related complications occur because hemostasis is obtained easily and because no major structures are near the radial artery. With double blood supply to the hand, radial artery occlusion is well tolerated. In 100 patients with collateral blood supply to the right hand, PTCA was attempted with 6F guiding catheters and rapid-exchange balloon catheters for exertional angina (87 patients) or nonexertional angina (13 patients). Angioplasty was attempted in 122 lesions (type A n = 67 [55%], Type B n = 37 [30%], and type C n = 18 [15%]). Pre- and post-PTCA computerized quantitative coronary analysis was performed. Radial artery function and structure were assessed clinically and with Doppler and two-dimensional ultrasound on the day of discharge. Coronary catheterization via the radial artery was successful in 94 patients (94%). The 6 remaining patients had successful PTCA via the femoral artery (n = 5) or the brachial artery (n = 1). Procedural success (120 of 122 lesions) was achieved in 92 patients (98%) via the radial artery and in 98 patients of the total study population.(ABSTRACT TRUNCATED AT 250 WORDS)

  8. Mechanical Recanalization of Subacute Vessel Occlusion in Peripheral Arterial Disease with a Directional Atherectomy Catheter

    Energy Technology Data Exchange (ETDEWEB)

    Massmann, Alexander, E-mail: Alexander.Massmann@uks.eu; Katoh, Marcus [Saarland University Hospital, Department of Diagnostic and Interventional Radiology (Germany); Shayesteh-Kheslat, Roushanak [Saarland University Hospital, Department of General Surgery, Visceral, Vascular, and Pediatric Surgery (Germany); Buecker, Arno [Saarland University Hospital, Department of Diagnostic and Interventional Radiology (Germany)

    2012-10-15

    Purpose: To retrospectively examine the technical feasibility and safety of directional atherectomy for treatment of subacute infrainguinal arterial vessel occlusions. Methods: Five patients (one woman, four men, age range 51-81 years) with peripheral arterial disease who experienced sudden worsening of their peripheral arterial disease-related symptoms during the last 2-6 weeks underwent digital subtraction angiography, which revealed vessel occlusion in native popliteal artery (n = 4) and in-stent occlusion of the superficial femoral artery (n = 1). Subsequently, all patients were treated by atherectomy with the SilverHawk (ev3 Endovascular, USA) device. Results: The mean diameter of treated vessels was 5.1 {+-} 1.0 mm. The length of the occlusion ranged 2-14 cm. The primary technical success rate was 100%. One patient experienced a reocclusion during hospitalization due to heparin-induced thrombocytopenia. There were no further periprocedural complications, in particular no peripheral embolizations, until hospital discharge or during the follow-up period of 1 year. Conclusion: The recanalization of infrainguinal arterial vessel occlusions by atherectomy with the SilverHawk device is technically feasible and safe. In our limited retrospective study, it was associated with a high technical success rate and a low procedure-related complication rate.

  9. A hybrid approach to appendicitis with right external iliac artery pseudo aneurysm: A case report.

    Science.gov (United States)

    Chandler, Benjamin T; Ryer, Evan J; Keyser, Benjamin M; Elmore, James R

    2017-01-01

    While acute appendicitis is a common surgical problem, the simultaneous occurrence of appendicitis and an infected iliac artery pseudoaneurysm is exceedingly rare. We report the successful treatment of an infected right external iliac artery pseudo aneurysm in the 1setting of acute appendicitis. The patient is an 83-year-old male who presents with severe sepsis, right lower quadrant and right leg pain. Additional past medical history is significant for rectal cancer status post resection and radiation therapy in 1997. Computed tomography (CT) on admission revealed a right iliopsoas muscle abscess, an inflamed Appendix and a pseudo aneurysm arising from the right external iliac artery. After consultations by multiple specialties, the plan was to proceed with percutaneous drainage of the abscess, antibiotic therapy and subsequent repair of the pseudoaneurysm. CT guided drainage of the iliopsoas abscess was performed with return of hemorrhagic fluid. Due to the concern of contained pseudoaneurysm rupture, the patient was taken for expedited repair. Due to the patient's frailty and hostile abdomen, we performed embolization of the right external iliac artery pseudoaneurysm with Amplatzer I plugs (St. Jude Medical, St. Paul MN) and left common femoral to right superficial femoral bypass with cryopreserved cadaveric femoral vein. Following pseudoaneurysm exclusion, continued percutaneous drainage and antibiotic therapy, the patient has done well with no further evidence of infection. Repair of infected pseudo aneurysms can prove challenging. Ongoing infection, a hostile surgical abdomen and patient frailty further complicates the treatment of these patients. This case displays a minimally invasive approach to this rare but morbid condition. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  10. Delayed appearance of hypaesthesia and paralysis after femoral nerve block

    Directory of Open Access Journals (Sweden)

    Stefan Landgraeber

    2012-03-01

    Full Text Available We report on a female patient who underwent an arthroscopy of the right knee and was given a continuous femoral nerve block catheter. The postoperative course was initially unremarkable, but when postoperative mobilisation was commenced, 18 hours after removal of the catheter, the patient noticed paralysis and hypaesthesia. Examination confirmed the diagnosis of femoral nerve dysfunction. Colour duplex sonography of the femoral artery and computed tomography of the lumbar spine and pelvis yielded no pathological findings. Overnight the neurological deficits decreased without therapy and were finally no longer detectable. We speculate that during the administration of the local anaesthetic a depot formed, localised in the medial femoral intermuscular septa, which was leaked after first mobilisation. To our knowledge no similar case has been published up to now. We conclude that patients who are treated with a nerve block should be informed and physician should be aware that delayed neurological deficits are possible.

  11. Rupture of true profunda femoris artery aneurysms. Two new cases

    DEFF Research Database (Denmark)

    Levi-Mazloum, Niels Donald; Schroeder, T V

    1996-01-01

    Atherosclerotic aneurysms of the deep femoral artery are very rare. We report the first 2 published Scandinavian cases. Both were present in elderly smoking men. They presented with acute local pain, swelling and circulatory collapse. Ultrasonography and angiography demonstrated femoral aneurysm ...... but it was only at operation that the relation to the deep femoral artery was established. Simple ligation of the deep femoral artery was performed in one case. The other patient had a 6 mm PTFE graft interpositioned. Both made an uneventful recovery....

  12. [Subtrochanteric femoral fractures].

    Science.gov (United States)

    Ulmar, B; Simon, S; Eschler, A; Mittlmeier, T

    2013-12-01

    Subtrochanteric femoral fractures are proximal femoral fractures which are located between the trochanter minor and an area of 3 cm below the minor trochanter on the femoral shaft. About 10-15% of all proximal femoral fractures correspond to this fracture site. Elderly or geriatric patients are generally affected and the injury is often the result of a fall in the home, while high-energy trauma is the cause in a small group of generally younger patients. Clinical evaluation of the affected extremity shows disability of axial weight-bearing and pain during compression and rotation of the hip joint. Basic diagnostics include conventional x-rays of the injured femur in the anterior-posterior and lateral planes. These subtrochanteric femoral fractures are almost always treated surgically due to the inherent high degree of instability. The main goals of surgical intervention are to achieve anatomic fracture reduction and primary full weight-bearing stability of the corresponding leg. Intramedullary interlocking nails are used for primary treatment, while extramedullary implants are often used in revision surgery. Early mobilization and intensive respiratory exercises are necessary to prevent early postoperative complications.

  13. Femoral bifurcation disease: balloon or knife.

    Science.gov (United States)

    Bosiers, Marc; Deloose, Koen

    2009-10-01

    Arterial occlusive disease at the level of the femoral bifurcation mostly occurs in combination with inflow and/or outflow lesions. Surgical endarterectomy of the femoral bifurcation is a well-proven low-risk and easy surgical intervention with known durable success, while, although proven to be safe, evidence is lacking about the durability of the endovascular approach. Based on the evidence at hand, the surgical approach should be recommended for the vast majority of patients and the endovascular approach should only be indicated as the first strategy in selected cases presenting with factors that might compromise the outcome of surgery in the groin. If feasible, the hybrid approach with endarterectomy at the level of the bifurcation and endovascular repair of the inflow and outflow lesions is preferred in patients with multilevel disease.

  14. Applied anatomy of a reverse medial femoral condyle periosteal flap pedicled with the infrapatellar branch of Descending Genicular artery%膝降血管髌下支蒂股骨内侧髁骨膜瓣逆行转位术的应用解剖

    Institute of Scientific and Technical Information of China (English)

    林金堆; 林加福; 郑和平; 徐皓

    2011-01-01

    Objective To provide anatomical basis of medial femoral condyle periosteal flap pedicled with the infrapatellar branch of the descending genicular artery for reconstruction of the knee joint.Methods 30 embalmed lower limbs of adult cadavers perfused with the red latex were used for this anatomical study.The adductor tubercle and medial femoral codyle were observational landmarks, the followings were observed: the course, branch and distribution of the branch of the desceding genicular artery to the knee joint.Results The articular branch of descending genicular artery above the inferior edge of medial femoral condyle (5.9±1.2)cm always gives off two mian branches: the periosteal branch and the infrapatellar branch.The original diameter of the periosteal branch is( 1.3±0.2 )mm, and it travels along the medial femoral condyle (4.8± 1.1)cm in length; the original diameter of the infrapatellar branch is(1.3±0.2)mm, and its length is (6.6±1.5)cm.Conclusion The medial femoral condyle periosteai flap pedicled with the infrapatellar branch of the descending genicular artery can be developed to repair bone injuries of knee joint.%目的 为膝降血管髌下支蒂股骨内侧髁骨膜瓣修复膝关节而缺损提供解剖学基础.方法 在30侧动脉内灌注红色乳胶的成人下肢标本上,以收肌结节、股骨内侧髁为观测点解剖观测膝降动脉关节支的走行、分支与分布.另在1侧新鲜标本上进行摹拟手术.结果 膝降血管关节支在距股骨内侧髁下缘上(5.9c1.2)cm处发出两大分支:①骨膜支起始外径(1.3±0.2)mm,在股骨内侧髁面上走行距离为(4.8±1.1)cm;②髌下支起始外径为(1.3±0.2)mm,向下走行距离为(6.6±1.5)cm.结论 可形成膝降血管髌下支一骨膜支蒂股骨内侧髁骨膜瓣逆行转位修复膝关节而缺损.

  15. Femoral varus: what's the angle

    DEFF Research Database (Denmark)

    Miles, James Edward; Svalastoga, Eiliv Lars; Eriksen, Thomas

    Agreement and reliability of femoral varus measurements: a comparison of four techniques Three different techniques have been described for measuring femoral varus radiographically in the dog, but how the measurements from these techniques compare is unknown. Further, measurement reliability has ...

  16. Nitrite and S-Nitrosohemoglobin Exchange Across the Human Cerebral and Femoral Circulation

    DEFF Research Database (Denmark)

    Bailey, Damian M; Peter, Rasmussen; Overgaard, Morten

    2017-01-01

    their relative contribution in vivo, we quantified arterial-venous concentration gradients across the human cerebral and femoral circulation at rest and during exercise, an ideal model system characterized by physiological extremes of O2 tension and blood flow. METHODS: Ten healthy participants (5 men, 5 women...... simultaneously from the brachial artery and internal jugular and femoral veins with plasma and RBC nitric oxide metabolites measured by tri-iodide reductive chemiluminescence. Blood flow was determined by transcranial Doppler ultrasound (cerebral blood flow) and constant infusion thermodilution (femoral blood......) in proportion to the reduction in RBC oxygenation (r=0.680-0.769, Parterial>venous; Parterial; P

  17. Laparoscopic repair of femoral hernia

    OpenAIRE

    Yang, Xue-Fei; Liu, Jia-Lin

    2016-01-01

    Laparoscopic repair of inguinal hernia is mini-invasive and has confirmed effects. Femoral hernia could be repaired through the laparoscopic procedures for inguinal hernia. These procedures have clear anatomic view in the operation and preoperatively undiagnosed femoral hernia could be confirmed and treated. Lower recurrence ratio was reported in laparoscopic procedures compared with open procedures for repair of femoral hernia. The technical details of laparoscopic repair of femoral hernia, ...

  18. Rapid intermittent compression increases skin circulation in chronically ischemic legs with infra-popliteal arterial obstruction.

    Science.gov (United States)

    van Bemmelen, P S; Weiss-Olmanni, J; Ricotta, J J

    2000-02-01

    Intermittent pneumatic compression (IPC) has been shown, by duplex, to increase popliteal artery flow in normal legs and in legs with superficial femoral artery occlusion. The objective of this study was to see if IPC improves distal circulation in legs with severe infra-popliteal disease. Sixteen chronically ischemic legs with arteriographically demonstrated crural or pedal disease were studied during compression with an ArtAssist compression-device. This device delivers rapid compression of the foot and calf. Cutaneous laser-Doppler flux was measured continuously at the dorsal aspect of the distal forefoot. The findings were compared to those in thirteen normal controls of similar age. In ischemic legs, the spontaneous changes in skin-flux are minimal: mean resting flux in sitting position was 0.87 +/- 0.46 AU (Arbitrary Units). Upon activation of the compression device the maximum flux increased to 4.55 +/- 1.35 AU. The difference was statistically significant (p < 0.001). This response was similar to that in normal controls. Arterial flow augmentation upon compression is associated with increased skin-flux. This response remains present in severe disease of the crural outflow-arteries. Further investigation to define the role of intermittent compression for management of chronic arterial disease is warranted.

  19. A STUDY ON SUPERFICIAL PALMAR ARCH AND IT’S VARIATIONS

    Directory of Open Access Journals (Sweden)

    Venkateswara Rao

    2015-03-01

    Full Text Available INTRODUCTION: Knowledge of the frequency of anatomical variations of arterial pattern of hand is crucial for safe and successful hand surgical approach, diagnostic and therapeutic procedures. The superficial pal mar arch is a major blood supply to the hand. Various ano malous patterns in the superficial arch of hand are reported. The superficial pal mar arch is formed predominantly by ulnar artery with a contribution from superficial branch of radial artery. OBSERVATIONS: Superficial palmar arch is dissected within the p alm and observed from its origin to termination. Variations in its origin, branches were observed. A classic superficial palmar arch was found in 10% [5/50]. O ut of dissected specimens complete arch found in 67% and incomplete arch was 33%. Incomplete arch is formed by ulnar artery alone. It supply four and half fingers and give five branches. Majority of arches is supplied by three and half fingers and gives four branches. DISCUSSION: Many attempts have been made to classify these variations. A complex cla ssification of superficial pal mar arch by Coleman & Anson [1961]. S ince then, many other classification have been suggested by different authors [Karlsson & N iechajev, 1982; al - Turk & Metcalf, 1984; Doscher et al. 1985; Ruengsakulrachh et al. 2001;] provi des simplest understanding of distribution of the arches. Although the classical pattern of the arch occurs in frequently, anatomical presence of a complete superficial palmar arch varies from 84% to 66% [Coleman & Anson]. This incidence was lower in the c urrent study and might be a reflection of sample size [52 hands]. The median artery was found in 10% of the hands, similar frequency to that reported by McCormack et al. [1953].

  20. Arterial protocol including prophylactic distal perfusion catheter decreases limb ischemia complications in patients undergoing extracorporeal membrane oxygenation.

    Science.gov (United States)

    Lamb, Kathleen M; DiMuzio, Paul J; Johnson, Adam; Batista, Philip; Moudgill, Neil; McCullough, Megan; Eisenberg, Joshua A; Hirose, Hitoshi; Cavarocchi, Nicholas C

    2017-04-01

    Venoarterial extracorporeal membrane oxygenation (ECMO) is a salvage therapy in patients with severe cardiopulmonary failure. Owing to the large size of the cannulas inserted via the femoral vessels (≤24-F) required for adequate oxygenation, this procedure could result in significant limb ischemic complications (10%-70%). This study evaluates the results of a distal limb perfusion arterial protocol designed to reduce associated complications. We conducted a retrospective institutional review board-approved review of consecutive patients requiring ECMO via femoral cannulation (July 2010-January 2015). To prevent arterial ischemia, a distal perfusion catheter (DPC) was placed antegrade into the superficial femoral artery and connected to the ECMO circuit. Limb perfusion was monitored via near-infrared spectroscopy (NIRS) placed on both calves. Decannulation involved open repair, patch angioplasty, and femoral thrombectomy as needed. A total of 91 patients were placed on ECMO via femoral arterial cannula (16-F to 24-F) for a mean duration of 9 days (range, 1-40 days). A percutaneous DPC was inserted prophylactically at the time of cannulation in 55 of 91 patients, without subsequent ischemia. Of the remaining 36 patients without initial DPC placement, 12 (33% without DPC) developed ipsilateral limb ischemia related to arterial insufficiency, as detected by NIRS and clinical findings. In these patients, the placement of a DPC (n = 7) with or without a fasciotomy, or with a fasciotomy alone (n = 4), resulted in limb salvage; only one patient required subsequent amputation. After decannulation (n = 7), no patients had further evidence of limb ischemia. Risk factors for the development of limb ischemia identified by categorical analysis included lack of DPC at time of cannulation and ECMO cannula size of less than 20-Fr. There was a trend toward younger patient age. Overall ECMO survival rate was 42%, whereas survival in patients with limb ischemia was only 25

  1. Hypothenar hammer syndrome: Distal ulnar artery reconstruction with autologous inferior epigastric artery.

    Science.gov (United States)

    Smith, Hadley E; Dirks, Marco; Patterson, Robert B

    2004-12-01

    Digital artery embolization and ulnar artery thrombosis are consequences of repetitive trauma and can lead to digit loss and debility from ischemia and cold intolerance. We postulate that an arterial autograft is a theoretically superior conduit to traditional saphenous vein, and report reconstruction with inferior epigastric artery. Three adult male smokers, ages 39 to 49 years, had severe digital ischemia and cold-induced vasospasm. Arteriograms confirmed occlusion of the distal ulnar artery without direct perfusion of the superficial palmar arch, distal digital artery embolization, and normal proximal vasculature. All reconstructions were performed from the distal most patent ulnar artery at the wrist to the superficial palmar arch (1 patient) or sequentially to the involved common digital arteries (2 patients), with inferior epigastric artery. Handling characteristics and size match between the arterial autografts and bypassed arteries was excellent. Patency has been confirmed with duplex scanning at follow-up of 8 to 24 months, with resolution of cold intolerance and successful digital preservation.

  2. 游离旋股外侧动脉降支皮瓣在小腿难治性创面软组织缺损的修复应用%The repair application of the lateral femoral cutaneous artery flap for soft tissue defects of refractory ;wounds on leg

    Institute of Scientific and Technical Information of China (English)

    刘伟; 刘圣曜; 刘强; 陈铭青; 严志强; 区广鹏; 黄瑞良; 余斌

    2016-01-01

    目的:游离旋股外侧动脉降支皮瓣在小腿难治性创面修复软组织缺损中的临床疗效。方法:2007年10月至2016年1月,先用VSD促进肉芽组织的生长,待肉芽组织生长满意后再应用游离旋股外侧动脉降支解剖特点设计皮瓣,修复创面缺损患者12例,旋髂浅腹股沟皮瓣8例,切取皮瓣后与受区血管吻合修复缺损创面。结果:20例患者随访,随访时间6~24个月,平均12个月,皮瓣全部成活,仅1例皮瓣边缘小面积坏死,经换药创面愈合,皮瓣色泽、质地良好。股四头肌肌力正常,膝关节伸、屈0°~150°。结论:旋股外侧动脉降支皮瓣修复难治性创面软组织缺损,皮瓣供区直接缝合,缩短治疗周期,安全有效,因此是修复创面组织缺损的理想皮瓣之一。%Objective The clinical effect of the lateral femoral cutaneous artery flap for soft tissue defects of leg wounds. Methods From October 2007 to January 2016, VSD was firstly used to promote the growth of granulation tissue. When the growth of granulation tissue became satisfactory, flaps were designed based on the anatomical characteristics of the lateral femoral cutaneous artery. We repaired 20 cases of wound defects by cutting flaps that coincide with the recipient vessels. Result 20 cases were followed up for 6 to 24 months, 12 months on average. All flaps were survived and only one case had small area of necrosis flap which was healed by replacing medicines. In all cases, wounds were healed and flaps showed good color and good texture. The strength of quadriceps muscle was good and the extension of knee flexion was 0° to 150°. Conclusion To The lateral femoral cutaneous artery flap is used for soft tissue defects of refractory wounds on leg , flap donor sites are sutured directly, the treatment period is shorten and the method is safe and effective. The lateral femoral cutaneous artery flap is one of ideal choices for wound tissue

  3. Estimation of pretraumatic femoral antetorsion in bilateral femoral shaft fractures

    Energy Technology Data Exchange (ETDEWEB)

    Citak, Musa; Jagodzinski, Michael; Krettek, Christian; Huefner, Tobias [Hannover Medical School, Trauma Department, Hannover (Germany); Citak, Mustafa [BG-University Hospital Bergmannsheil, Department of Surgery, Bochum (Germany); Kendoff, Daniel; O' Loughlin, Padhraig F. [Hospital for Special Surgery, Orthopaedic Department, New York, NY (United States); Tavassol, Frank [Hannover Medical School, Department of Oral and Maxillofacial Surgery, Hannover (Germany)

    2009-12-15

    To describe a system for measurement of the pretraumatic femoral antetorsion angle post-bilateral femoral shaft fracture with the use of new imaging software which allows segmentation and three dimensional (3D) reconstruction of DICOM (digital imaging and communications in medicine) images. This case involved a 20-year-old patient with bilateral femoral shaft fractures. Following initial clinical examination, CT scans of both femurs were performed. Subsequently, the DICOM datasets were uploaded to the new software tool. Following segmentation and 3D reconstruction, pretraumatic femoral antetorsion angles were determined. Femoral antetorsion was described and assessed in two ways by referring to the intersection of the posterior condylar plane and (1) a line drawn between the center of the femoral head and femoral neck, (2) a line drawn between the centers of the femoral head and greater trochanter. Using these definitions, values for femoral antetorsion were found to be, respectively, 20 at the right fracture site and 19 on the left site, and 33 bilaterally. The investigators describe in this current technical report the use of new imaging software which enables the calculation of femoral AV following reduction of virtual fracture fragments which are created from standard DICOM images. We believe that this 3D reconstruction method of measuring the antetorsion angle can be integrated into a regular treatment algorithm and may potentially optimize clinical outcomes. (orig.)

  4. 带腓动脉的腓浅神经营养血管皮瓣修复前足软组织缺损%Reconstruction of forefoot soft tissue defect with superficial peroneal neurotropphic vascular flap with peroneal artery

    Institute of Scientific and Technical Information of China (English)

    李俊明; 李艳华; 易先达; 李智浩; 黄贺军; 李道选; 代彭威; 贺喜顺

    2013-01-01

    Objective To observe the clinical effect of retrograde transferring of Superficial peroneal nerve nutrition vessel flap for repairing the soft tissue defect of forefoot.Methods From January 2007 to December 2011,twelve patients with soft tissue defect in forefoot were treated with superficial peroneal nerve nutrition vessel flap by retrograde transfer repair.The flap ranged in size from 6 cm × 4 cm to 18 cm × 12 cm.Results Only 1 flap appeared blood stasis and swelling,and the distal end of skin flap became effusion under the epidermis.Considering it may because we sew it up too tight,we removed sort of suture timely.The flap became ruddy and survived.And the others smoothly survived without special handling.Eight patients had our follow-up visit and they were satisfied with the shape of their flaps,the flap was wear-resisting.Five cases get followed-up of the 7 patients which had neural anastomosis surgery,the 2PD was 10-14 mm of the flap.Conclusion With a good shape,this type of flap supplying with plentiful blood,easily chipped,transferred with a strong randomness,is one of the ideal methods to repair the rather large area skin soft tissue defect in the forefoot.%目的 总结带腓动脉的腓浅神经营养血管皮瓣逆行转位修复前足皮肤软组织缺损的临床效果. 方法 2007年1月至2011年12月,应用带腓动脉的腓浅神经营养血管皮瓣逆行转移对12例前足皮肤软组织缺损进行修复,皮瓣切取面积为6cm×4cm~18cm×12cm. 结果 仅1例术后36 h出现皮瓣瘀血肿胀,皮瓣远端出现表皮下积液,与蒂部缝合过紧有关,及时拆除蒂部部分缝线,皮瓣转红润,顺利成活,其余皮瓣均顺利成活.8例得到3个月~3年的随访,皮瓣外形满意,耐磨.吻合神经的7例中有5例得到随访,皮瓣两点辨别觉在10 ~ 14 mm. 结论 带腓动脉的腓浅神经营养血管皮瓣血供丰富,切取简便,随意转移性强,外观好,是修复前足较大面积皮肤软组织缺损理想的方法之一.

  5. Contralateral reversed distal femoral locking plate for fixation of subtrochanteric femoral fractures

    Institute of Scientific and Technical Information of China (English)

    Paritosh Gogna; Reetadyuti Mukhopadhyay; Amanpreet Singh; Ashish Devgan; Sahil Arora; Amit Batra; Sushil Kumar Yadav

    2015-01-01

    Purpose:Subtrochanteric fractures of the femur are being managed successfully with various intramedullary and extramedulary implants with reasonable success.However,these implants require precise placement under image intensifier guidance,which exposes the surgeon to substantial amount of radiation.It also restricts the management of these fractures at peripheral centers where facility of image intensifiers is not available.Keeping this in mind we designed this study to identify if contralateral reversed distal femoral locking plate can be used successfully without the use of image intensifier.Methods:Twenty-four consecutive patients (18 men and 6 women) with a mean age of 28 years (range 19-47 years) suffering subtrochanteric fractures of the femur underwent open reduction and internal fixation with reversed contralateral distal femoral locking plate.The outcome was assessed at the mean follow-up period of 3.2 years (range 2-4.6 years) using the Harris hip score.Results:Twenty-one fractures united with the primary procedure,with a mean time of consolidation being 11 weeks (range,9-16 weeks).One patient developed superficial suture line infection,which resolved with oral antibiotics.Another patient had a fall 3 weeks after surgery and broke the plate.Repeat surgery with reversed distal femoral locking compression plate was performed along with bone grafting and the fracture united.Two cases had nonunion,which went in for union after bone grafting.The mean Harris hip score at the time of final follow-up was 90.63 (range 82-97).Conclusion:The reversed contralateral distal femoral plate is a biomechanically sound implant,which when used for fixation of the subtrochanteric fractures with minimal soft tissue stripping shows results comparable to those achieved by using other extramedullary implants as well as intramedullary devices.The added advantage of this implant is its usability in the absence of an image intensifier.

  6. STUDY OF PROFUNDA FEMORIS ARTERY OF HUMAN CADAVERS IN RAJKOT CITY, INDIA

    Directory of Open Access Journals (Sweden)

    Pradip R. Chauhan

    2015-03-01

    Full Text Available Background: The profunda femoris artery is the major branch of the femoral artery. It is at critical place in relation to femoral artery for various interventions. Aim: To study the origin of profunda femoris artery. And to compare the cross sectional area of profunda femoris artery between right and left limbs. Material and methods: In this cross sectional study, 51 human femoral triangles from 26 (18 male and 08 female human cadavers in P.D.U. Government Medical College, Rajkot were dissected and studied during regular dissection classes. Site of origin of profunda femoris artery was noted in relation to femoral artery. The distance of origin of profunda femoris artery from the midpoint of inguinal point was measured and noted. Circumference of profunda femoris artery at the level of origin was measured. The cross sectional area was calculated. Collected data was analyzed by standard statistical formulas with the help of Microsoft excel 2007 and Epi info TM 7 software. Result: Most common (52.95% cases site of origin was posterolateral from femoral artery. The mean distance of origin of profunda femoris artery from the midpoint of inguinal ligament was 30.17 mm. There was no significant difference in cross sectional area of right and left profunda femoris artery (at 95% confidence interval Conclusion: Profunda femoris artery is used for angiography, ultrasonography and cardiac catheterization also. It is the major blood supply of the thigh. Its relations with femoral artery, femoral vein and femoral nerve makes it important structure for clinicians. Variations in origin of profunda femoris artery must be considered to avoid complication like aneurism and faulty passage of the catheter. High origin of profunda femoris artery is more prone to damage while accessing femoral artery.

  7. Radiation induced femoral palsy

    Energy Technology Data Exchange (ETDEWEB)

    Aranda, B.; Esnault, S.; Brunet, P. (Hopital de la Salpetriere, Paris (France))

    1982-01-01

    We report four cases of femoral palsy due to compressive fibrosis, after pelvic radiation therapy. Three patients had Hodgkin's disease, and one testicular seminoma. Prominent clinical features include major groin induration and underlying swelling. Unlike what is usually seen in tumoral relapse, little or no pain is associated with these neuropathies. The femoral post-radic palsy develops earlier and faster than brachial plexus palsy of same aetiology. In one case, progressive aggravation led to surgical neurolysis which resulted in dramatic and long lasting improvement. The principal preventive and therapeutic management methods are discussed: since compressive fibrosis is related to the use of isolated and massive electron beam therapy, various associations of cobalt and electron beam therapy are designed to best prevent the side effects of each of these methods. The early treatment of developing fibrosis by D. penicillamine is discussed.

  8. Proximal femoral fractures

    DEFF Research Database (Denmark)

    Palm, Henrik; Teixidor, Jordi

    2015-01-01

    BACKGROUND: In hip fracture surgery, the exact choice of implant often remains somewhat unclear for the individual surgeon, but the growing literature consensus has enabled publication of evidence-based surgical treatment pathways. The aim of this article was to review author pathways and national...... guidelines for hip fracture surgery and discuss a method for future pathway/guideline implementation and evaluation. METHODS: By a PubMed search in March 2015 six studies of surgical treatment pathways covering all types of proximal femoral fractures with publication after 1995 were identified. Also we...... searched the homepages of the national heath authorities and national orthopedic societies in West Europe and found 11 national or regional (in case of no national) guidelines including any type of proximal femoral fracture surgery. RESULTS: Pathway consensus is outspread (internal fixation for un...

  9. Proximal Focal Femoral Deficiency

    Directory of Open Access Journals (Sweden)

    Vishal Kalia, Vibhuti

    2008-01-01

    Full Text Available Proximal focal femoral deficiency (PFFD is a developmental disorder of the proximal segment of thefemur and of acetabulum resulting in shortening of the affected limb and impairment of the function. It isa spectrum of congenital osseous anomalies characterized by a deficiency in the structure of the proximalfemur. The diagnosis is often made by radiological evaluation which includes identification and descriptionof PFFD and evaluation of associated limb anomalies by plain radiographs. Contrast arthrography orMagnetic Resonance Imaging is indicated when radiological features are questionable and to disclose thepresence and location of the femoral head and any cartilagenous anlage. The disorder is more commonlyunilateral and is apparent at birth. However, bilateral involvement is rarely seen. Therapy of the disorder isdirected towards satisfactory ambulation and specific treatment depending on the severity of dysplasia.

  10. Proximal Focal Femoral Deficiency

    OpenAIRE

    Vishal Kalia, Vibhuti

    2008-01-01

    Proximal focal femoral deficiency (PFFD) is a developmental disorder of the proximal segment of thefemur and of acetabulum resulting in shortening of the affected limb and impairment of the function. It isa spectrum of congenital osseous anomalies characterized by a deficiency in the structure of the proximalfemur. The diagnosis is often made by radiological evaluation which includes identification and descriptionof PFFD and evaluation of associated limb anomalies by plain radiographs. Contra...

  11. Femoral and carotid subclinical atherosclerosis association with risk factors and coronary calcium: the AWHS study

    Science.gov (United States)

    BACKGROUND: Early subclinical atherosclerosis has been mainly researched in carotid arteries. The potential value of femoral arteries for improving the predictive capacity of traditional risk factors is an understudied area. OBJECTIVES: This study sought to evaluate the association of subclinical ca...

  12. Pharmacokinetics of Mitomycin C Following Hepatic Arterial Chemoembolization With Gelfoam

    OpenAIRE

    Jin Wen Ding; Zai de Wu; Roland Andersson; Stig Bengmark

    1992-01-01

    Twelve mongrel dogs were randomly allocated into two groups using matched paired-design. Catheters were inserted into the hepatic artery, hepatic vein and the femoral vein, respectively. In the first group, gelfoam supplemented with mitomycin C (MMC) was injected into the hepatic artery, whereas the second group received a hepatic arterial injection of MMC solution alone. Simultaneous blood sampling from the hepatic and femoral veins at regular intervals was performed. MMC concent...

  13. Pharmacokinetics of Mitomycin C Following Hepatic Arterial Chemoembolization With Gelfoam

    OpenAIRE

    Ding, J. W.; Wu, Z. D.; Andersson, R.; S. Bengmark

    1992-01-01

    Twelve mongrel dogs were randomly allocated into two groups using matched paired-design. Catheters were inserted into the hepatic artery, hepatic vein and the femoral vein, respectively. In the first group, gelfoam supplemented with mitomycin C (MMC) was injected into the hepatic artery, whereas the second group received a hepatic arterial injection of MMC solution alone. Simultaneous blood sampling from the hepatic and femoral vein at regular intervals was performed. MMC concentrations in pl...

  14. The iliac periosteal flap with ascending branch of lateral femoral circumflex artery for the treatment of Legg-Calvé-Perthes disease%带旋股外侧动脉升支髂骨骨膜瓣植入治疗儿童股骨头缺血性坏死

    Institute of Scientific and Technical Information of China (English)

    傅维民; 赵德伟; 王本杰; 马志杰; 王建川

    2015-01-01

    目的 探讨应用带旋股外侧动脉升支髂骨骨膜瓣植入治疗儿童股骨头缺血性坏死的临床效果及意义. 方法 分析自2008年1月至2012年5月在我院应用带旋股外侧动脉升支髂骨骨膜瓣植入治疗的18例患者资料.随访时间24~60个月,平均38个月,随访时间截止2014年5月.随访时行X线片检查并进行临床体格检查,Harris评分系统评估手术效果. 结果 X线见16例患者术后骨膜瓣愈合良好,骨骺高度逐渐恢复,股骨头变圆.2例股骨头出现变扁、塌陷.Mose法结合X线所得结果优良率为88.9%.Harris评分从术前平均(72.3±4.9)分提高到术后平均(91.3±2.4)分,两者比较差异有统计学意义(P<0.05). 结论 应用带旋股外侧动脉升支髂骨骨膜瓣植入是儿童股骨头缺血性坏死的一种有效治疗方法.%Objective To investigate the clinical effect of the iliac periosteal flap with ascending branch of lateral femoral circumflex artery for the treatment of Legg-Calvé-Perthes disease.Methods Followed-up 18 patients with Legg-Calvé-Perthes disease who had undergone the treatment of iliac periosteal flap with ascending branch of lateral femoral circumflex artery from January,2008 to May,2012 in our hospital.Minimum follow-up time was from 24 to 60 months,and the average time was 38 months.The followed-up period ended in May,2014.Assessed the effect of surgery by X-ray,clinical examination and Harris scoring system.Results Sixteen patients had good healing with iliac periosteal flap according to X-ray show.Their epiphyseal height recovered and the femoral head rounded gradually.Two cases became flat and collapse.The result of excellent and good rate was 88.9% by Mose method combined with the results of X-ray.The average Harris hip score improved from 72.3 ± 4.9 points preoperatively to 91.3 ± 2.4 points postoperatively.The difference of the result was statistically significant (P < 0.05).Conclusion The transfer of iliac periosteal

  15. Superficial Priming in Episodic Recognition

    Science.gov (United States)

    Dopkins, Stephen; Sargent, Jesse; Ngo, Catherine T.

    2010-01-01

    We explored the effect of superficial priming in episodic recognition and found it to be different from the effect of semantic priming in episodic recognition. Participants made recognition judgments to pairs of items, with each pair consisting of a prime item and a test item. Correct positive responses to the test item were impeded if the prime…

  16. Prediction of Coronary Artery Disease by B-Mode Sonography

    Directory of Open Access Journals (Sweden)

    J Kheirkhah

    2010-09-01

    Full Text Available Background: Although coronary angiography is gold standard for diagnosis of coronary artery disease, it is nevertheless an invasive and potentially hazardous procedure. The aim of this study was to investigate the predictive value of carotid and femoral artery Intima-Media Thickness (IMT for detection of coronary artery disease.Methods: The present study comprised 100 consecutive patients referred for coronary angiography due to symptoms of ischemic heart disease. Ultrasound assessment of common carotid and common femoral artery were performed with an ultrasound device equipped with a high-resolution transducer. IMT was measured in the common carotid and common femoral artery (10 mm proximal to the deep femoral artery origin. Results: There were 25 cases in each of single (S, double (D and triple (T vessel disease and 25 in significant left main diseases groups of patients. In regard to common carotid artery IMT was 0.78 mm in S, 0.84 mm in D, 0.97 mm in T and 1.05 mm in left main disease groups. There was a significant correlation between IMT measured in the carotid artery and severity of coronary artery disease (P = 0.0001. With respect to common femoral artery IMT was 0.66 mm in S group, 0.73 mm in D group, 0.84 mm in T groups and 0.85 mm in patients with left main disease.. There is a significant correlation between IMT (measured in the common femoral artery and severity of coronary artery disease (P = 0.0001.Conclusion: Our results indicated that early atherosclerosis in both carotid and femoral arteries were highly predictive of coronary involvement and IMT being associated with the number of coronary vessels disorder.

  17. 旋髂浅动脉穿支嵌合骨皮瓣修复四肢骨与软组织缺损%Transplantation of the chimerical osteocutaneous perforator flap with superficial circumflex iliac artery for repair of bone and skin defect in limbs

    Institute of Scientific and Technical Information of China (English)

    潘朝晖; 蒋萍萍; 薛山; 刘学胜; 李洪飞; 赵玉祥

    2010-01-01

    目的 探讨旋髂浅动脉穿支嵌合骨皮瓣修复四肢骨与软组织缺损的应用特点.方法 2008年2月至2009年4月应用旋髂浅动脉穿支嵌合骨皮瓣修复四肢骨与软组织缺损5例,男4例,女1例;年龄22~44岁,平均31.2岁.车祸伤3例,机器挤压伤2例.掌骨2例,足2例,腓骨1例.皮肤缺损面积5 cm×2 cm~16 cm×5 cm.骨瓣切取范围2 cm×1 cm×0.8 cm~8 cm×2 cm×0.5 cm,皮瓣切取范围6cm×3 cm~18 cm×6 cm.血管吻合除1例动脉端侧吻合外,均采用端端吻合方式.骨瓣以钢板螺钉固定4例,克氏针固定1例.结果 1例术后第2天出现动脉危象,探查后发生皮瓣边缘浅表性坏死,经植皮愈合,其余皮瓣全部存活.供区伤口8~27 d愈合.全部患者随访8~19个月,皮瓣外观满意,无须特殊保护.骨愈合时间3~6个月.髋部外形轮廓未改变,无髋区疼痛,无瘢痕增生.修复手部缺损者患手恢复握持功能,基本恢复对掌功能;修复下肢缺损者患肢可负重,无疼痛.结论 旋髂浅动脉穿支嵌合骨皮瓣供区损伤小,是修复小面积骨缺损,尤其是合并较大范围软组织缺损的一种较好方法.%Objective To investigate the applied methods and effects of the chimerical osteocuta-neous perforator flap with superficial circumflex iliac artery for reconstruction of bone and skin defect in limbs. Methods From February 2008 to April 2009, five patients in whom bone and skin defect in limbs were reconstructed with free chimerical osteocutaneous perforator flaps using superficial circumflex iliac vessel, in-cluding 4 males and 1 female with an average age of 31.2 years. Of 5 patients, 2 were used for the recon-struction of composite metacarpal bone and soft-tissue defects, 2 for foot reconstruction, and 1 for fibula re-construction. The area of cutaneous deficiency was about 5 cm×2 cm to 16 cm×5 cm. The size of osseous flaps ranged from 2 cm×1 cm×0.8 cm to 8 cm×2 cm×0.5 cm, and the size of cutaneous flaps ranged

  18. 注射毒品致股动脉感染性假性动脉瘤破裂出血的手术治疗%Surgical treatment for rupture and hemorrhage of infected femoral artery pseudoaneurysm caused by drug injection

    Institute of Scientific and Technical Information of China (English)

    付强; 郭晓静

    2013-01-01

    Objective To explore the surgical treatment for rupture and hemorrhage of infected femoral artery pseudoaneurysms(IFAP) caused by drug injection.Methods A total of 17 patients with rupture and hemorrhage of IFAP caused by drug injection were treated with emergency operation.The proximate external iliac artery was exposed by making a incision perpendicular to the groin,after the external iliac artery was clamping tentatively,the blood flow signals of pedal artery were observed by Doppler flow detector.Fourteen patients with blood flow signals of pedal artery were treated with simple femoral artery ligation and aneurysm excision.Three patients without blood flow signals of pedal artery were treated with aneurysm excision and reconstructive vascular operation.Among the three cases,one case was treated with autogenous saphenous vein grafting in situ,the other two cases were treated with iliofemoral vascular prosthesis bypass grafting.Results A total of 17 patients were successfully performed with debridement and excision of IFAP,the incisions in 10 cases were primary healing,the incisions in 6 cases were per secunda intentionem,the unstitched incisions in 1 case healed by changing dressings 2 months later,the average stay was(21.0 ± 4.5)days.The leucocyte count and neutrophil ratio at the moment of leaving hospital were significantly lower than those before operation(P < 0.05).The peripheral saturation of blood oxygen of affected extremity in the 3 cases with vascular reconstruction after operation was significantly higher than that before operation(P < 0.05) ;3 weeks after operation,the ultrasound examination showed that the grafts were smooth.All of the patients were followed-up for(10.2 ± 2.6)months,there was no amputation and death,10 patients with mild intermittent claudication recovered within 1 year; the basic walking function in all patients were restored.Conclusions Selective vascular reconstruction operation for rupture and hemorrhage of IFAP caused by

  19. Delayed Femoral Nerve Palsy Associated with Iliopsoas Hematoma after Primary Total Hip Arthroplasty

    Directory of Open Access Journals (Sweden)

    Sandeep Kumar

    2016-01-01

    Full Text Available Femoral nerve neuropathy after total hip arthroplasty is rare but catastrophic complication. Pain and quadriceps muscle weakness caused by this complication can significantly affect the functional outcome. Here we present a case report, describing delayed onset femoral nerve palsy associated with iliopsoas hematoma following pseudoaneurysm of a branch of profunda femoris artery after 3 months of primary total hip arthroplasty in an 80-year-old female patient with single kidney. Hip arthroplasty was done for painful primary osteoarthritis of left hip. Diagnosis of femoral nerve palsy was made by clinical examination and computed tomography imaging of pelvis. Patient was managed by surgical evacuation of hematoma and physiotherapy. The patient’s clinical symptoms were improved after surgical evacuation of hematoma. This is the first case report of its kind in English literature regarding delayed onset femoral nerve palsy after primary total hip arthroplasty due to pseudoaneurysm of a branch of profunda femoris artery without any obvious precipitating factor.

  20. [Complications after the use of a StarClose® vascular closure device for femoral punctures].

    Science.gov (United States)

    Quintana Martínez, I; Guillén Subirán, M E; Zaragozano Guillén, R; Hilario González, J

    2014-01-01

    The StarClose(®) arterial device (Abbot Vascular Devices, Abbot Laboratories, Redwood City, CA, USA) rapidly seals a femoral artery puncture by means of a nitinol clip in the adventitia of the artery. It is a safe and effective device, with advantages as regards manual compression, but is not free of complications. We present two cases with complications after using a StarClose(®) vascular device.

  1. Estudio de la vascularización arterial del músculo flexor digitorum superficialis Anatomical study of the arterial vascularization of the flexor digitorum superficialis muscle

    Directory of Open Access Journals (Sweden)

    N. Comellas Melero

    2010-03-01

    Full Text Available El objetivo de nuestro estudio es describir la distribución de la vascularización del músculo flexor digitorum superficialis para optimizar sus indicaciones en Cirugía Reconstructiva de miembro superior. Disecamos 15 antebrazos fijados según el método Thiel y coloreados mediante la inyección de látex en los vasos femorales. Centramos nuestro estudio en la disección del músculo flexor digitorum superficialis, seleccionando únicamente los pedículos vasculares que superan los 2 mm, valorando los resultados en función de sus relaciones anatómicas y de su longitud. El número total hallado de arterias nutrientes del vientre muscular fue de 219, localizándose en mayor porcentaje en el tercio medio del antebrazo. De los resultados obtenidos de nuestro estudio podemos deducir que las arterias cubital y cubital recurrente aportan la vascularización dominante. Medialmente, el músculo recibe ramas de la arteria cubital y cubital recurrente, en la parte profunda del vientre muscular. Lateral y proximalmente, recibe ramas de la arteria mediana, mientras que lateral y distalmente recibe ramas de la arteria radial, que penetran en la superficie del músculo.We present an anatomical study that describes the distribution of the muscular perforators of the flexor digitorum superficialis muscle. In this study we dissected 15 forearms fixed according to Thiel method and coloured latex injection in the femoral vessels.The study was centered on the flexor digitorum superficialis muscle. Only muscular perforator arteries with diameters over 2mm were selected. The vascular origin and length were also studied. In all cases, measurements were taken from the bicondyle line. The total number of arteries obtained from the muscle belly was 219, with the greatest percentage located in the half of the forearm. The principal vascular origin of the perforator arteries was the cubital artery. From the results obtained in our work, we can deduce that the ulnar and

  2. Quadratus lumborum block for femoral–femoral bypass graft placement

    Science.gov (United States)

    Watanabe, Kunitaro; Mitsuda, Shingo; Tokumine, Joho; Lefor, Alan Kawarai; Moriyama, Kumi; Yorozu, Tomoko

    2016-01-01

    Abstract Introduction: Atherosclerosis has a complex etiology that leads to arterial obstruction and often results in inadequate perfusion of the distal limbs. Patients with atherosclerosis can have severe complications of this condition, with widespread systemic manifestations, and the operations undertaken are often challenging for anesthesiologists. Case report: A 79-year-old woman with chronic heart failure and respiratory dysfunction presented with bilateral gangrene of the distal lower extremities with obstruction of the left common iliac artery due to atherosclerosis. Femoral–femoral bypass graft and bilateral foot amputations were planned. Spinal anesthesia failed due to severe scoliosis and deformed vertebrae. General anesthesia was induced after performing multiple nerve blocks including quadratus lumborum, sciatic nerve, femoral nerve, lateral femoral cutaneous nerve, and obturator nerve blocks. However, general anesthesia was abandoned because of deterioration in systemic perfusion. The surgery was completed; the patient remained comfortable and awake without the need for further analgesics. Conclusion: Quadratus lumborum block may be a useful anesthetic technique to perform femoral–femoral bypass. PMID:27583851

  3. Femoral pseudoaneurysms in drug addicts

    DEFF Research Database (Denmark)

    Levi-Mazloum, Niels Donald; Rørdam, Peter; Jensen, L P

    1997-01-01

    OBJECTIVE: To evaluate the outcome of treatment of femoral pseudoaneurysms in drug addicts. METHODS: The records of eight patients undergoing vascular surgery for femoral pseudoaneurysms from substance abuse identified from a vascular database were reviewed. RESULTS: Were good in four out of five...

  4. Superficie

    OpenAIRE

    Corna, Pablo María

    2015-01-01

    En la época posclásica del derecho romano se buscó, por parte del Estado y ciudadanos, utilizar ciertos terrenos que formaban parte de su patrimonio para arrendarlos por largo término —y a veces a perpetuidad— a personas que tenían el derecho de edificar o plantar mediante el pago de un precio llamado pensio o solárium. En el siglo II de nuestra era ya era utilizado para asentar tribus romanizadas en la frontera del imperio como para el cultivo de vid y los olivos que demoran varios...

  5. Superficie

    OpenAIRE

    Corna, Pablo María

    2015-01-01

    En la época posclásica del derecho romano se buscó, por parte del Estado y ciudadanos, utilizar ciertos terrenos que formaban parte de su patrimonio para arrendarlos por largo término —y a veces a perpetuidad— a personas que tenían el derecho de edificar o plantar mediante el pago de un precio llamado pensio o solárium. En el siglo II de nuestra era ya era utilizado para asentar tribus romanizadas en la frontera del imperio como para el cultivo de vid y los olivos que demoran varios años e...

  6. Percutaneous Aspiration Thrombectomy for Arterial Thromboembolism during Infrainguinal Endovascular Recanalization.

    Directory of Open Access Journals (Sweden)

    Li-Ming Wei

    Full Text Available To evaluate the efficacy of percutaneous aspiration thrombectomy (PAT for infrainguinal arterial thromboembolism in patients undergoing endovascular recanalization (EVR and to investigate the predictors for thromboembolic complications.In total, 23 patients (23 limbs who underwent PAT for thromboembolism (PAT group, PG during EVR and 237 patients (302 limbs who underwent successful EVR without thromboembolic complications (control group, CG were enrolled. Immediate post-operation and follow-up outcomes were compared between the two groups. Multivariate analysis was performed to identify the predictors of thromboembolic complications. Technical success of PAT was defined as achievement of <30% residual stenosis and restoration of mTIMI grade 3.The technical success rate was 95.7% in PG. After intervention, the ankle-brachial index (ABI, restoration of blood flow and improvement in dorsal/plantar arterial pulse score showed no significant differences between PG and CG. During follow-up in PG, a sustained ABI improvement was observed in 63.6% (70.9% in CG, an improvement in walking distance in 68.8% (79.9% in CG,, ulcer healing in 75.0% (71.7% in CG and restenosis/occlusion in 31.8% (25.2% in CG. The limb salvage rate was 100% in PG (96.0% in CG, and pain relief was observed in 66.7% patients with critical limb ischaemia (81.6% in CG. Superficial femoral artery involvement [0.233; 95% confidence interval (CI, 0.108-0.461; P < 0.001], de-novo lesion occlusion (683.8; 95% CI, 36.5-12804.6; P < 0.001 and intraluminal angioplasty (118.4; 95% CI, 8.0-1758.0; P = 0.001 was associated with high incidence of thromboembolism.PAT is a safe and effective treatment for thromboembolism during infrainguinal arterial EVR. SFA involvement, de-novo lesion occlusion and intraluminal angioplasty may be predictors of thromboembolic complications.

  7. Subclavian artery resection and reconstruction for thoracic inlet neoplasms.

    Science.gov (United States)

    Mercier, Olaf; Su, Xiao-Dong; Lahon, Benoit; Mussot, Sacha; Fabre, Dominique; Delemos, Alexandra; Le Chevalier, Thierry; Dartevelle, Philippe G; Fadel, Elie

    2015-12-01

    To update the long-term outcomes after subclavian artery (SA) resection and reconstruction during surgery for thoracic inlet (TI) cancer through the anterior transclavicular approach. Between 1985 and 2014, 85 patients (60 men and 25 women; mean age, 52 years) underwent en bloc resection of thoracic-inlet non-small cell lung cancer (NSCLC) (n=69), sarcoma (n=11), breast carcinoma (n=3) or thyroid carcinoma (n=2) involving the SA. L-shaped transclavicular cervicothoracotomy was performed, with posterolateral thoracotomy in 18 patients or a posterior midline approach in 15 patients. Resection extended to the chest wall (>2 ribs, n=60), lung (n=76), and spine (n=15). Revascularization was by end-to-end anastomosis (n=48), polytetrafluoroethylene (PTFE) graft interposition (n=28), subclavian-to-common carotid artery transposition (n=8), or grafting of the autologous superficial femoral artery in an anterolateral thigh free flap (n=1). Complete R0 resection was achieved in 75 patients and microscopic R1 resection in 10 patients. Postoperative radiation therapy was given to 51 patients. There were no cases of postoperative death, neurological sequelae, graft infection or occlusion, or limb ischemia. Postoperative morbidity consisted of pneumonia (n=16), phrenic nerve palsy (n=2), recurrent nerve palsy (n=4), bleeding (n=4), acute pulmonary embolism (n=1), cerebrospinal fluid leakage (n=1), chylothorax (n=1), and wound infection (n=2). Five-year survival and disease-free survival rates were 32% and 22%, respectively. Long-term survival was not observed after R1 resection. Subclavian arteries invaded by TI malignancies can be safely resected and reconstructed through the anterior transclavicular approach, with good long-term survival provided complete R0 resection is achieved.

  8. Local denervation of sympathetic nerve from the femoral artery using 6-hydroxydopamine in a rabbit model%6-羟多巴胺去除股动脉交感神经的动物模型建立及相关研究

    Institute of Scientific and Technical Information of China (English)

    靳宇飞; 李富航; 毕龙; 裴国献

    2014-01-01

    目的 探讨6-羟多巴胺(6-OHDA)在体内去除兔股动脉交感神经的可行性,以期为研究单纯血管本身在组织工程骨中有无神经化作用提供理想的动物实验模型. 方法 分离16只新西兰兔右侧股动脉,采用不同药物处理:实验组采用含0.1 mg/mL 6-OHDA和质量百分比为0.1%抗坏血酸Krebs缓冲液处理,为确定药物干预后交感神经的恢复时间,将实验组再分为7d、14d和28 d取材组(n=4);对照组(n=4)采用仅含0.1%抗坏血酸Krebs缓冲液处理.分别用苏木精-伊红(HE)染色、乙醛酸激发单胺荧光染色检测股动脉组织变化、交感神经分布情况,并通过Western blot检测酪酸羟化酶(TH)和神经肽Y(NPY)蛋白表达水平的差异. 结果 HE染色结果显示:与对照组相比,3个取材组股动脉组织血管壁结构完整,无明显形态学改变.乙醛酸激发单胺荧光染色结果显示:对照组股动脉可见大量交感神经呈网状和放射状分布;7d和14 d取材组几乎不可见交感神经,28 d取材组有少量交感神经.Western blot检测结果表明:对照组、7d取材组、14d取材组及28 d取材组TH/β-actin比值平均分别为0.70±0.08、0.19±0.08、0.20±0.06、0.33 ±0.06; NPY/β-actin比值平均分别为0.68±0.14、0.14±0.02、0.17±0.02、0.53±0.10,各取材组的TH和NPY蛋白表达量较对照组均显著减少,而28 d取材组的TH和NPY蛋白表达量较7d、14d取材组明显增多,差异均有统计学意义(P<0.05). 结论 体内局部应用6-OHDA可有效去除股动脉交感神经纤维,是一种可行的血管壁去交感神经方法.本研究建立了一种理想的化学去股动脉交感神经的动物模型.%Objective To explore an effective method to remove sympathetic nerve from the femoral artery in a rabbit model.Methods Femoral arteries from 16 New Zealand rabbits were separated and treated with different drugs.The femoral arteries were processed with Krebs buffer containing 0.1 mg/mL 6

  9. Simultaneous proximal femoral rotational and distal femoral varus osteotomies for femoral retroversion and genu valgum.

    Science.gov (United States)

    Wagner, Russell; Barcak, Eric A

    2012-04-01

    Whereas excess femoral anteversion and its related symptoms have been described many times, excess femoral retroversion is less well documented. We report the case of a 30-year-old woman who had a history of chronic bilateral hip and knee pain and evidence of excess femoral retroversion, genu valgum, early-onset lateral and patellofemoral compartment osteoarthritis of both knees, and hip arthritis. She experienced symptomatic relief after undergoing staged bilateral simultaneous proximal femoral rotational and distal femoral lateral opening wedge osteotomies. Although this combination of alignment problems is not an infrequent clinical occurrence, we have found no literature on this condition or treatment. The patient provided written informed consent for print and electronic publication of this case report.

  10. Aneurysms of the superficial venous system: classification and treatment

    Directory of Open Access Journals (Sweden)

    Ronald G. Bush

    2014-11-01

    Full Text Available Superficial venous aneurysms are rarely described and they may remain indolent or become the source for pulmonary emboli. A system of classification and treatment protocol according to size and location is proposed. Three hundred thirty patients were evaluated for symptomatic venous disease (C2-C6 over a 2-year period. A proposed designation for venous aneurysm is described. Patients fulfilling this criterion are described in reference to site of involvement, histologic findings, and method of treatment. Five percent of patients met the criteria for venous aneurysm. Nine aneurysms of the greater saphenous vein were identified. Three aneurysms were proximal to the subterminal valve and the rest were distal. Six aneurysms of the anterior accessory greater saphenous vein (AAGSV were identified. Three aneurysms of the AAGSV spontaneously thrombosed. Two patients presented with aneurysms of the small saphenous vein. Histology revealed thickened intima, smooth muscle and adventitia. Aneurysm designation relates to diameter of normal and contiguous vein. All superficial venous aneurysms in close proximity to the junction of the femoral or popliteal vein should be ligated. Classification of venous aneurysms should include the AAGSV, which may present with spontaneous thrombosis.

  11. Deep venous thrombosis and pulmonary embolism caused by an intravascular synovial sarcoma of the common femoral vein.

    Science.gov (United States)

    Schoneveld, J M; Debing, E; Verfaillie, G; Geers, C; Van den Brande, P

    2012-11-01

    Malignant tumors arising in deep veins of the lower extremities are very uncommon. To our best knowledge, this is the seventh case of a primary venous intravascular synovial sarcoma (SS) reported in literature. A 32-year-old woman was admitted with a second episode of deep venous thrombosis of the right lower limb and pulmonary embolism. Physical and radiological examinations showed besides the thrombosis a tumor arising from the right common femoral vein involving the bifurcation of the common femoral artery. At surgery, en block resection of the tumor including the deep femoral vein and arterial bifurcation was done with an arterial reconstruction using a synthetic graft. Histopathological examination revealed an intravascular SS of the common femoral vein. The mainstay of curative therapy is complete surgical resection of all tumor manifestations with negative histological margins.

  12. Focal femoral condyle resurfacing.

    LENUS (Irish Health Repository)

    Brennan, S A

    2013-03-01

    Focal femoral inlay resurfacing has been developed for the treatment of full-thickness chondral defects of the knee. This technique involves implanting a defect-sized metallic or ceramic cap that is anchored to the subchondral bone through a screw or pin. The use of these experimental caps has been advocated in middle-aged patients who have failed non-operative methods or biological repair techniques and are deemed unsuitable for conventional arthroplasty because of their age. This paper outlines the implant design, surgical technique and biomechanical principles underlying their use. Outcomes following implantation in both animal and human studies are also reviewed. Cite this article: Bone Joint J 2013;95-B:301-4.

  13. Bilateral femoral hernia in a male cadaver with vascular variations: case report and review of the literature.

    Science.gov (United States)

    Natsis, K; Totlis, T; Papadopoulou, A L; Apostolidis, S; Skandalakis, P

    2006-08-01

    Femoral hernia, which is a less common occurrence than inguinal hernia, is not congenital in most cases and is uncommon in young males. It is considered to be more common in females than in males due to an enlarged femoral ring in the former. A case of bilateral femoral hernia in a 64-year-old male cadaver is described within the framework of an anatomical approach. On the right side, the protrusion of the viscus appeared as a small intestine coil, whereas on the left side the protruded viscus appeared as a pelvic colon's appendix appiplocae. On both sides, the protruded viscus was located in front of an aberrant obturator artery, which oriented from the external iliac artery and not from the internal iliac artery as should be the case. The puberal branch of the inferior epigastric artery was absent. The cadaver's medical history and his skin examination excluded an abdominal surgery. In the literature, case reports of bilateral femoral hernia appear only seldom, especially those of male patients who had not undergone inguinal hernia repair surgery. In femoral hernias more often than in other types of hernia, the protruded viscus is strangulated and undergoes a tissue necrosis. Morbidity and mortality for complicated femoral hernia is high. Knowledge of vascular variation such as presented by the cadaver under study is extremely useful to the surgeon because any iatrogenic injury of the aberrant obturator artery during a laparoscopic repair may result in dangerous hemorrhage.

  14. Aneurysm of the superficial palmar arch: a case report.

    Science.gov (United States)

    Estrella, Emmanuel P; Lee, Ellen Y

    2008-01-01

    Aneurysms of the hand are uncommon lesions. The most common location is the ulnar artery. We present a case of a young female who consulted us for a hand mass with a history of trauma to the hand. Pre-operative arteriogram showed a superficial palmar arch aneurysm. The mass was excised and the arch was reconstructed using a reversed Y-shaped vein graft. Fourteen months after surgery, there was no recurrence of the aneurysm and the patient only reported occasional cold intolerance.

  15. FEMORAL MONONEUROPATHY: COMPLICATING A DIFFICULT PELVIC URETEROLITHOTOMY

    Directory of Open Access Journals (Sweden)

    D. Mehraban

    1996-07-01

    Full Text Available Femoral mononeuropathy is a complication of gynecological and urological operations. Tlte objective of this citse report is to bring to the attention of fellow urologists the very existence of this complication and offer measures to prevent it. A 48 year old obese worman with a 2 year history of frequent left renal colics, anil a nonfunction left kidney on IVP underwent a retrograde ureterogram study anil a transvaginal ureterolithotomy, in an exaggerated lithotomy position. Postoperatively, a left leg paralysis required 3 weeks of care and encouragement to heal. To prevent this complication, avoid putting too long and too much pressure by retractors on the psoas muscles. During the abdomino-perineal procedures, frequent change of retractor site and monitoring of distal arterial pulses would he helpful. Also, do not use the exaggerated lithotomy position for an extended period of time.

  16. [Femoral varus osteotomy combined with interlocking nailing for treatment of genu valgum].

    Science.gov (United States)

    Wang, Huimin; Tan, Mingsheng; Li, Zirong; Yang, Feng; Liang, Li; Zhang, Guangbo

    2005-03-15

    To assess the effect of medial distal femoral osteotomy combined with interlocking nailing on the treatment of knee osteoarthritis with valgus deformity. From May 1996 to August 2000, 16 patients with knee osteoarthritis accompanied by valgus deformity were treated by medial wedged distal femoral osteotomy combined with interlocking nailing. Full-length radiographs were taken before operation and 8 weeks and 2 years after operation. The parameters, including the femorotibial angle, the tibial angle, the femoral angle, the femoral condyle-tibial plateau angle, and the lateral joint space, were measured by these radiographs. The function of knee was evaluated by the 100-point rating scale standard of knee. The mean postoperative score was significantly improved from 50.4 +/- 15.9 points to 78.5 +/- 12.9 points 2 years after the surgery. The lateral joint space was increased from 2.1 +/- 1.8 mm to 4.7 +/- 1.7 mm and the femoral condyle-tibial angle decreased from 5.6 +/- 2.9 degrees to 1.6 +/- 3.4 degrees. There were complications in 2 cases: 1 case of delayed union and 1 case of superficial wound infection. Medial distal femoral osteotomy combined with interlocking nailing proves to be an effective approach to treat knee osteoarthritis with valgus deformity.

  17. Relationship Between Carotid-femoral Pulse Wave Velocity and Severity of Coronary Artery Lesions Measured by SYNTAX Score%颈-股脉搏波速度与冠状动脉病变严重程度关系的研究

    Institute of Scientific and Technical Information of China (English)

    陈炳伟; 王志广; 党爱民; 柳青; 吕纳强; 杨跃进

    2015-01-01

      结论:作为评估主动脉僵硬度的“金标准”,cfPWV与冠脉病变程度有相关性。%Objective: To explore the relationship between carotid-femoral pulse wave velocity (cfPWV) and the severity of coronary artery lesions measured by SYNTAX score. Methods:A total of 319 patients who received the ifrst time coronary angiography were studied. SYNTAX score evaluation was conducted to assess the severity of coronary lesions and the patients were divided into 3 groups:Control group, the subjects without coronary stenosis≥50%, n=118, the rest 201 patients were divided as Low SYNTAX score (1-17.5) group, n=96 and High SYNTAX score (18-72) group, n=105. The cfPWV was measured in all patients, the relationship between SYNTAX score and cfPWV was studied by Ordinal logistic regression analysis, the accuracy for cfPWV predicting SYNTAX scoring was assessed by ROC analysis. Results: With the adjusted factors of age, gender, obesity, smoking, family history of CAD, mean blood pressure, TC, HDL-C, ankle-brachial index (ABI), hypertension, hyperlipidaemia and diabetes, SYNTAX score was obviously related to cfPWV (OR=1.24, P=0.006). Further analysis for both High and Low SYNTAX score groups, the relationship between cfPWV and SYNTAX score was more close in patients with male gender, non-obesity, smoking, diabetes and non-hypertension. The accuracy for cfPWV predicting SYNTAX scoring had the higher sensitivity in patients with SYNTAX≥33 (ROC=0.703). Conclusion: As golden standard for measuring aortic stiffness, cfPWV is related to the severity of coronary artery lesions in relevant patients.

  18. A comparison of Percutaneous femoral access in Endovascular Repair versus Open femoral access (PiERO) : study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    Vierhout, Bastiaan P.; Saleem, Ben R.; Ott, Alewijn; van Dijl, Jan Maarten; de Kempenaer, Ties D. van Andringa; Pierie, Maurice E. N.; Bottema, Jan T.; Zeebregts, Clark J.

    2015-01-01

    Background: Access for endovascular repair of abdominal aortic aneurysms (EVAR) is obtained through surgical cutdown or percutaneously. The only devices suitable for percutaneous closure of the 20 French arteriotomies of the common femoral artery (CFA) are the Prostar (TM) and Proglide (TM) devices

  19. 改良强制性运动疗法对老年偏瘫患者下肢步行能力和股动脉血流变化的影响%Influences of modified constraint-induced movement therapy on lower-extremity walking ability and blood flow of femoral artery among elderly patients with stroke

    Institute of Scientific and Technical Information of China (English)

    王文清; 李小彬; 卢建丽; 李艳双; 瓮长水; 毕胜

    2012-01-01

    目的 观察改良强制性运动疗法(mCIMT)对老年脑卒中偏瘫患者下肢运动功能和股动脉血流的变化. 方法 入选老年偏瘫患者67例,随机分为mCIMT组(35)例,平均年龄(73.2±5.2)岁和常规神经发育技术(NDT)对照组(32)例,平均年龄(76.4±3.8)岁.治疗前后分别采用10m最大步行速度(MWS)、Berg平衡量表(BBS)、“起立-行走”计时测试(TUGT)和简式Fugl-Meyer (FMA-L)进行下肢功能评定,同时用彩色多普勒超声观察患侧下肢股动脉的血流速度和管腔直径的变化. 结果 mCIMT治疗后除FMA-L评分与NDT组比较差异无统计学意义外[(35.24±7.62)分比(31.32±3.28)分,t=19.99,P>0.05)],其他3项评分MWS[(56.68±6.57)分比(45.61±5.34)分]、BBS[(46.84±4.05)分比(29.84±4.05)分]、TUGT[(14.55±8.25)分比(25.35±8.70)分]明显高于NDT组(t=15.09,17.38,15.25,均P=0.001).6周mCIMT治疗后管腔直径[(9.05±1.15)nun比(8.05±0.68) mm,t=6.72,P=0.001]和血流速度[(92.55±18.25)cm/s比(69.35±8.7)cm/s,t=6.83,P=0.001]明显大于NDT对照组. 结论 mCIMT能明显提高老年脑卒中偏瘫患者的下肢运动功能,提高股动脉的血流速度.%Objective To observe the influences of modified constraint-induced movement therapy (mCIMT)on lower-extremity walking ability and femoral artery blood flow among elderly patients with stroke. Methods Totally 67 patients with stroke were randomly divided into mCIMT group(n =35) aged ( 73.2 ± 5.2 ) years and neurodevelopmental treatment (NDT) group ( n =32) as control aged(76.4 ± 3.8) years.Patients in control group exercised by NDT 2 h/time,2 times/d,5 d/week for 6 weeks. Patients in mCIMT group exercised including:" up and down" exercise,100-120 times/d; movement flatbed exercise for 16-20 min/d; upstairs and downstairs exercise,balance training,standing in a single leg exercise,mandatory exercise time of lower-extremity about 4 h/d,5 d/week for 6 weeks.The patients were assessed for lower-extremities motor function

  20. Femoralni trikotnik: The femoral triangle:

    OpenAIRE

    Mlakar, Boštjan; Ravnik, Dean

    1999-01-01

    The topography and structures of the femoral triangle are presented. The femorai triangle lies between the inguinal ligament at the base, the sartoriusmuscle at the lateral border and the long adductor muscle at the medial border. The apex of the femoral triangle is situated at the meeting point of the medial borders of the sartorius and long adductor muscles. The subinguinal space, which is divided into the lacuna musculorum and lacuna vasorum, provides a passageway for the lateral cutaneous...

  1. The role of AO external fixation in proximal femoral osteotomies in the pediatric neuromuscular population.

    Science.gov (United States)

    Handelsman, John E; Weinberg, Jacob; Razi, Afshin; Mulley, Debra A

    2004-09-01

    Internal fixation in proximal femoral osteotomies using traditional devices may be sub-optimal in children with neuromuscular disorders who have small or osteopenic bone. In this population, between 1988 and 2000, we performed 36 proximal femoral varus osteotomies in 28 patients. These were controlled by the AO external fixator. The average age at surgery was 7 years (range, 2-13 years). A mean varus correction of 34 degrees (range, 15-90 degrees) was obtained. Complications consisted of one superficial pin tract infection, one skin breakdown, and one non-union. Other than the non-union, all osteotomies were stable at the time of the fixator removal. The AO external fixator is an effective alternative in maintaining corrective proximal femoral osteotomies in children with fragile bones.

  2. Pseudoaneurisma de artéria poplítea secundário a osteocondroma femoral: relato de caso

    Directory of Open Access Journals (Sweden)

    Fabricio Mascarenhas de Oliveira

    Full Text Available Osteochondromas are the most common benign tumor of the bone. They are sometimes responsible for vascular complications involving either veins or arteries, principally around the knee. Pseudoaneurysms are considered a rare condition. The authors describe the occurrence of a pseudoaneurysm of the popliteal artery in association with a femoral osteochondroma in a 30-years-old man.

  3. A Rare Variant of the Ulnar Artery with Important Clinical Implications: a Case Report

    OpenAIRE

    Casal Diogo; Pais Diogo; Toscano Tiago; Bilhim Tiago; Rodrigues Luís; Figueiredo Inês; Aradio Sónia; Angélica-Almeida Maria; Goyri-O’Neill João

    2012-01-01

    Abstract Background Variations in the major arteries of the upper limb are estimated to be present in up to one fifth of people, and may have significant clinical implications. Case presentation During routine cadaveric dissection of a 69-year-old fresh female cadaver, a superficial brachioulnar artery with an aberrant path was found bilaterally. The superficial brachioulnar artery originated at midarm level from the brachial artery, pierced the brachial fascia immediately proximal to the elb...

  4. Pigmented Villonodular Synovitis Causing Osteonecrosis of the Femoral Head: A Case Report

    Directory of Open Access Journals (Sweden)

    Tomohiro Mimura

    2013-01-01

    Full Text Available We report a case of a 27-year-old man with pigmented villonodular synovitis of the hip joint with coincident osteonecrosis of the femoral head. According to our review of the English-language literature, no detailed report of osteonecrosis of the femoral head complicated with pigmented villonodular synovitis has been published. Preoperative X-ray images showed joint narrowing and severe multiple bone erosions at the acetabulum and femoral neck. Magnetic resonance imaging revealed a low-intensity band attributable to osteonecrosis of the femoral head and massive diffuse pigmented villonodular synovitis lesions. Comparison of a three-dimensional computed tomographic image of this patient with an angiographic image of a normal individual demonstrated proximity of the pigmented villonodular synovitis-induced bone erosions to the medial and lateral femoral circumflex arteries and retinacular arteries, suggesting likely the compromise of the latter by the former. We propose that the massive pigmented villonodular synovitis may have contributed to the pathogenesis of osteonecrosis of the femoral head in this patient. We performed open synovectomy and total hip arthroplasty. No operative complications occurred, and no recurrence of the pigmented villonodular synovitis was detected for 3 years after the operation.

  5. Safety and feasibility of femoral catheters during physical rehabilitation in the intensive care unit.

    Science.gov (United States)

    Damluji, Abdulla; Zanni, Jennifer M; Mantheiy, Earl; Colantuoni, Elizabeth; Kho, Michelle E; Needham, Dale M

    2013-08-01

    Femoral catheters pose a potential barrier to early rehabilitation in the intensive care unit (ICU) due to concerns, such as catheter removal, local trauma, bleeding, and infection. We prospectively evaluated the feasibility and safety of physical therapy (PT) in ICU patients with femoral catheters. We evaluated consecutive medical ICU patients who received PT with a femoral venous, arterial, or hemodialysis catheter(s) in situ. Of 1074 consecutive patients, 239 (22%) received a femoral catheter (81% venous, 29% arterial, 6% hemodialysis; some patients had >1 catheter). Of those, 101 (42%) received PT interventions, while the catheter was in situ, for a total of 253 sessions over 210 medical ICU (MICU) days. On these 210 MICU days, the highest daily activity level achieved was 49 (23%) standing or walking, 57 (27%) sitting, 25 (12%) supine cycle ergometry, and 79 (38%) in-bed exercises. During 253 PT sessions, there were no catheter-related adverse events giving a 0% event rate (95% upper confidence limit of 2.1% for venous catheters). Physical therapy interventions in MICU patients with in situ femoral catheters appear to be feasible and safe. The presence of a femoral catheter should not automatically restrict ICU patients to bed rest. Copyright © 2013 Elsevier Inc. All rights reserved.

  6. Late sequelae of superficial irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Hood, I.C.; Young, J.E.

    1984-10-01

    Superficial irradiation results in well recognized late sequelae including not only sclerosis and atrophy of skin and subcutaneous tissue, but also the development of benign and malignant tumors of skin and adjacent structures. The long latency between irradiation and its late effects allowed the early uncontrolled use of radiation treatment for benign conditions. The subsequent recognition of the causal relationship between tumors and previous irradiation has restricted its use to more appropriate purposes, although it is possible that it is still overused in some areas of dermatologic practice. Clinicians need to be aware of the time interval between irradiation and the development of its late sequelae, and the incidence of these sequelae. Appropriate irradiation exposure history should be a part of the evaluation of every patient.

  7. PERSISTENT MEDIAN ARTERY IN THE CARPAL TUNNEL

    Directory of Open Access Journals (Sweden)

    Raviprasanna.K.H

    2014-09-01

    Full Text Available Introduction: Persistent median artery originates from the anterior interosseous artery in proximal one-third of the forearm and accompanies median nerve. Median artery may regress in the forearm or enter palm through the carpal tunnel deep to flexor retinaculum of wrist and supply palm by anastomosing with the superficial palmar arch. Objective: In present study the objective was to study presence of persistent median artery accompanying median nerve and its termination Materials and Methods: The study included 50 human cadaver upper limb specimens at the Department of Anatomy, Mysore Medical College & Research Institute, Mysore during 2011-13. These specimens fixed in 10% formalin were finely dissected and persistent median artery was traced from origin to termination. Results: Out of 50 human cadaver specimens, persistent median artery was present in 4 specimens (8%. All the 4 median arteries originated from anterior interosseous artery and were of palmar type which reached palm. Out of 4 median arteries, 3 median arteries (6% took part in completion of superficial palmar arch, supplying the distal aspect of palm and 1 median artery (2% directly supplied radial two and half fingers without forming arch. Conclusion: Knowledge of unusual variations helps in proper treatment of disorders of the median nerve. Presence of persistent median artery usually will be asymptomatic but may cause symptoms of carpal tunnel syndrome or pronator teres syndrome when subjected to compression. Rarely this artery can be taken for reconstruction

  8. The surgical treatment of ilio-femoral venous obstruction.

    Science.gov (United States)

    Illuminati, G; Caliò, F G; D'Urso, A; Mancini, P; Papaspyropoulos, V; Ceccanei, G; Lorusso, R; Vietri, F

    2004-01-01

    A series of 9 patients of a mean age of 48 years, operated on for compression of the ilio-femoral venous axis is reported. The cause of obstruction was external compression in 3 cases, a retroperitoneal sarcoma in 1 case, and an infrarenal aortic aneurysm in 2. Two patients presented with a Cockett's syndrome, 3 with a chronic ilio-femoral thrombosis, and one with a post-traumatic segmentary stenosis. Treatment consisted in a resection/Dacron grafting of 2 infrarenal aortic aneurysms, one femoro-caval bypass graft, 2 transpositions of the right common iliac artery in the left hypogastric artery for Cockett's syndrome, 3 Palma's operations for chronic thrombosis, and one internal jugular vein interposition for segmentary stenosis. There were no postoperative deaths and no early thromboses of venous reconstructions performed. All the patients were relieved of symptoms during the follow-up period, whose mean length was 38 months. The cause of venous obstruction and the presence of symptoms which are resistant to medical treatment are the main indications to ilio-femoral venous revascularization. The choice of the optimal treatment in each single case yields satisfactory results.

  9. Regional variation in arterial stiffening and dysfunction in Western diet-induced obesity.

    Science.gov (United States)

    Bender, Shawn B; Castorena-Gonzalez, Jorge A; Garro, Mona; Reyes-Aldasoro, Constantino C; Sowers, James R; DeMarco, Vincent G; Martinez-Lemus, Luis A

    2015-08-15

    Increased central vascular stiffening, assessed in vivo by determination of pulse wave velocity (PWV), is an independent predictor of cardiovascular event risk. Recent evidence demonstrates that accelerated aortic stiffening occurs in obesity; however, little is known regarding stiffening of other disease-relevant arteries or whether regional variation in arterial stiffening occurs in this setting. We addressed this gap in knowledge by assessing femoral PWV in vivo in conjunction with ex vivo analyses of femoral and coronary structure and function in a mouse model of Western diet (WD; high-fat/high-sugar)-induced obesity and insulin resistance. WD feeding resulted in increased femoral PWV in vivo. Ex vivo analysis of femoral arteries revealed a leftward shift in the strain-stress relationship, increased modulus of elasticity, and decreased compliance indicative of increased stiffness following WD feeding. Confocal and multiphoton fluorescence microscopy revealed increased femoral stiffness involving decreased elastin/collagen ratio in conjunction with increased femoral transforming growth factor-β (TGF-β) content in WD-fed mice. Further analysis of the femoral internal elastic lamina (IEL) revealed a significant reduction in the number and size of fenestrae with WD feeding. Coronary artery stiffness and structure was unchanged by WD feeding. Functionally, femoral, but not coronary, arteries exhibited endothelial dysfunction, whereas coronary arteries exhibited increased vasoconstrictor responsiveness not present in femoral arteries. Taken together, our data highlight important regional variations in the development of arterial stiffness and dysfunction associated with WD feeding. Furthermore, our results suggest TGF-β signaling and IEL fenestrae remodeling as potential contributors to femoral artery stiffening in obesity.

  10. Retrograde arterial leg blood flow during tilt-back from a head-up posture: importance of capacitive flows when arterial pressure changes.

    Science.gov (United States)

    Sheriff, Don D; Nådland, Inger Helene; Toska, Karin

    2010-03-01

    The windkessel function of the arterial system converts the intermittent action of the heart into more continuous microcirculatory blood flow during diastole via the return of elastic energy stored in the walls of the arteries during systole. Might the same phenomenon occur regionally within the arterial system during tilting owing to regional differences in local arterial pressure imposed by gravity? We sought to test the hypothesis that during tilt-back from a head-up posture, the return of stored elastic energy in leg arteries would work to slow, or perhaps transiently reverse, the flow of blood in the femoral artery. Femoral artery blood flow and arterial pressure were recorded during tilt back from a 30 degrees head-up posture to supine (approximately 0.5 G) in young, healthy subjects (n = 7 males and 3 females) before and during clonidine infusion. During control (no drug) conditions femoral artery blood flow ceased for an entire heart beat during tilt-back. During clonidine infusion femoral artery blood flow reversed for at least one entire heart beat during tilt-back, i.e., blood flow in the retrograde direction in the femoral artery from the leg into the abdomen. Thus substantial capacitive effects of tilting on leg blood flow occur in humans during mild changes in posture.

  11. A Technique of Superficial Medial Collateral Ligament Reconstruction Using an Adjustable-Loop Suspensory Fixation Device.

    Science.gov (United States)

    Deo, Shaneel; Getgood, Alan

    2015-06-01

    This report describes superficial medial collateral ligament reconstruction of the knee using a novel method of graft fixation with the ACL Tightrope RT (Arthrex, Naples, FL). After tibial fixation with either a standard interference screw or staple, femoral fixation of the semitendinosus tendon is performed with the adjustable-loop suspensory fixation device, which allows for both initial graft tensioning and re-tensioning after cyclical knee range of motion. This provides the ability for the graft to accommodate for resultant soft-tissue creep and stress relaxation, thereby allowing for optimal soft-tissue tension and reduction in laxity at the end of the procedure.

  12. Arterial responses during migraine headache

    DEFF Research Database (Denmark)

    Iversen, Helle Klingenberg; Nielsen, T H; Olesen, J

    1990-01-01

    The superficial temporal artery has been thought to be the main focus of pain during migraine attacks, but its diameter has never been measured directly. The use of a new, high-resolution ultrasound machine to measure arterial size in 25 migraine patients with unilateral head pain showed...... that the lumen was wider on the painful than on the non-painful side during a migraine attack. The diameters of both radial arteries and the temporal artery on the non-painful side were smaller during than between attacks. The generalised vasoconstriction was not shared by the temporal artery on the affected...... side, which suggests a local vasodilatory response. The findings suggest that cephalic arteries may play a role in migraine pathogenesis....

  13. Superficial siderosis in the central nervous system

    Energy Technology Data Exchange (ETDEWEB)

    Pythinen, J. [Oulu Univ. (Finland). Dept. of Diagnostic Radiology; Paeaekkoe, E. [Oulu Univ. (Finland). Dept. of Diagnostic Radiology; Ilkko, E. [Oulu Univ. (Finland). Dept. of Diagnostic Radiology

    1995-02-01

    We describe a rare entity, superficial siderosis of the central nervous system, due to multiple small episodes of subarachnoid haemorrhage from any source. Non-specific neurological findings are associated with deposition of iron-containing pigments in the leptomeninges and superficial layers of the cortex. T2-weighted magnetic resonance imaging demonstrates characteristic low signal in the meninges. (orig.)

  14. Preinguinal Splitting and Reunion of Femoral Nerve Entrapping the Fleshy Fibres of Iliacus Muscle - A Case Report.

    Science.gov (United States)

    Ashwini, L S; Somayaji, S Nagabhooshana; Rao, Mohandas; Marpalli, Sapna

    2017-04-01

    Division of nerves close to their origin and muscular entrapments by nerves in the limbs is not very common. Femoral nerve is the largest branch of the lumbar plexus and arises from dorsal divisions of ventral rami of L2 to L4 spinal nerves. During routine cadaveric dissection for first year medical students at Melaka Manipal Medical College (Manipal Campus), Karnataka, India, we observed a variation in the division and course of left femoral nerve in about 65-year-old male cadaver. The femoral nerve was split into two divisions above the inguinal ligament after its origin from the lumbar plexus. The lower division of the nerve passed deep to the iliopsoas muscle fibres and the upper division ran superficial to iliacus muscle deep to fascia iliaca. Both the divisions joined just above the inguinal ligament to form the trunk of the femoral nerve. Further course and distribution of the nerve was normal. The reports have shown that compression neuropathies of femoral nerve in the limbs are caused by neoplastic masses, vascular abnormalities and also by different anomalous muscles. Such neuropathies may also result from indirect compression of femoral nerve between the fibres of psoas major muscle and lateral pelvic wall. The potential clinical importance of above mentioned variations in the division of femoral nerve would emphasize the surgeons to diagnose the neuromuscular entrapments and consequent alterations of sensation in the anterior and medial aspects of the thigh.

  15. In vivo evaluation of femoral blood flow measured with magnetic resonance

    DEFF Research Database (Denmark)

    Henriksen, O; Ståhlberg, F; Thomsen, C;

    1989-01-01

    Quantitative measurements of blood flow based on magnetic resonance imaging (MRI) using conventional multiple spin echo sequences were evaluated in vivo in healthy young volunteers. Blood flow was measured using MRI in the femoral vein. The initial slope of the multiple spin echo decay curve...... that in vivo blood flow measurements made with MRI based on wash-out effects, commonly used in multiple spin echo imaging, do not give reliable absolute values for blood flow in the femoral artery or vein......., corrected for the T2 decay of non-flowing blood was used to calculate the blood flow. As a reference, the blood flow in the femoral artery was measured simultaneously with an invasive indicator dilution technique. T2 of non-flowing blood was measured in vivo in popliteal veins during regional circulatory...

  16. Malformação ílio-femoral

    OpenAIRE

    2006-01-01

    Durante uma dissecção de rotina realizada em um cadáver do sexo masculino com 65 anos de idade foi constatada malformação arterial iliofemoral. A aorta abdominal estava consideravelmente deslocada lateralmente e também bifurcava em nível mais alto. A artéria ilíaca comum dividia-se uma vértebra acima do nível normal e a artéria femoral dava origem à artéria femoral profunda aproximadamente l,2 cm abaixo do ligamento inguinal, o que é consideravelmente proximal ao seu nível normal. Aqui nós ap...

  17. Recurrent femoral hernia and associated ovarian pathology.

    Science.gov (United States)

    Gately, Ryan Patrick; Concannon, Elizabeth Sarah; Hogan, A; Ryan, R S; O'Leary, M; Barry, K

    2012-08-27

    The following case describes an ovarian tumour presenting in a highly unusual manner-in the form of a recurrent femoral hernia. Recurrent femoral herniae are unusual and should prompt awareness of underlying pathology causing increased intra-abdominal pressure.

  18. Cochlear implantation in superficial siderosis.

    Science.gov (United States)

    Kim, Chong-Sun; Song, Jae-Jun; Park, Min-Hyun; Kim, Young Ho; Koo, Ja-Won

    2006-08-01

    Superficial siderosis (SS) of the central nervous system has been thought to be a rare condition that generates progressive hearing loss, ataxia, pyramidal signs, and dementia. The main cause of hearing loss by SS is thought to be neuronal. Because there is no histopathologic report of the human temporal bone in SS, there is a debate about the possibility of cochlear involvement. We present a 25-year-old man who was investigated for bilateral progressive sensorineural hearing loss and vestibular failure after head trauma. On brain MRI, SS of the central nervous system was detected. Distortion product otoacoustic emission (DPOAE) and auditory brainstem response (ABR) showed no response on both sides. However, integrity of the eighth nerve was proved by the electrical ABR test on the right side and the patient benefited significantly from cochlear implantation. The sensorineural hearing loss in SS seems to be related to cochlear damage as well as neuronal damage. So, cochlear implantation would be a hearing rehabilitation modality for the sensorineural hearing loss caused by SS.

  19. Silicon superficial texturing bypulsed laser

    Directory of Open Access Journals (Sweden)

    Ponce, L.

    1998-04-01

    Full Text Available Texturing of silicon surfaces with pulsed laser is made. The method is based on the formation of laser- induced periodic surface structure (LIPSS. The process is temporary characterized through the dynamic reflectance, thus determining the formation threshold of the structure. Relation between the different textures and the spectral reflectance of the samples before and after the treatment is also characterized. The mean value of spectral reflectance decreases up to a 6 %.

    Se realiza el texturado de superficies de silicio con un láser pulsado mediante la formación de una estructura periódica inducida por láser (LIPSS. Se caracteriza el proceso mediante reflectancia dinámica, determinándose el umbral de formación de la estructura. Se caracteriza el nivel de texturado midiendo la reflectancia espectral de las muestras antes y después del tratamiento. El valor medio de la reflectancia espectral disminuye hasta el 6 %.

  20. Femoral hernia; Clinical significance of radiologic diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Bergenfeldt, M.; Lasson, A. (Lund University (Sweden). Department of Surgery Malmo General Hospital (Sweden)); Ekberg, O.; Kesek, P. (Lund University (Sweden). Department of Radiology Malmo General Hospital (Sweden))

    A retrospective study of 18 patients with femoral hernia assessed by herniography is presented. Although a palpable lump was present in 11 patients (61%), the diagnosis of a femoral hernia was not made before herniography. Surgical exploration was performed in 12 patients and a femoral hernia was found and repaired with beneficial outcome in 9 of them. In conclusion: herniography is of value for the diagnosis of a femoral hernia in patients with obscure groin pain. (author). 14 refs.; 2 figs.

  1. Dynamic gadolinium-enhanced MRI evaluation of porcine femoral head ischemia and reperfusion

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, T. [Clinic for Orthopaedics and Sports Traumatology, Dreifaltigkeits-Krankenhaus GmbH, Aachener Str. 445-449, 50933 Koeln (Germany); Drescher, W. [Department of Orthopaedics, Christian Albrechts University, Kiel (Germany); Becker, C. [Department of Orthopaedics, Heinrich Heine University, Duesseldorf (Germany); Sangill, R.; Stoedkilde-Joergensen, H. [Institute for Magnetic Resonance Imaging Tomography, University of Aarhus, Skejby Hospital, Aarhus (Denmark); Heydthausen, M. [Computing Center, Heinrich Heine University, Duesseldorf (Germany); Hansen, E.S.; Buenger, C. [Spine Section, Department of Orthopaedics, University of Aarhus (Denmark)

    2003-02-01

    To examine the potential of gadolinium (Gd)-enhanced dynamic MRI in the detection of early femoral head ischemia. Furthermore, to apply a three-compartment model to achieve a clinically applicable MR index for femoral head perfusion during the steady state and arterial hip joint tamponade.Design and materials In a porcine model femoral head perfusion was measured by radioactive tracer microspheres and by using a dynamic Gd-enhanced MRI protocol. Femoral head perfusion measurements and MRI tests were performed unilaterally before, during and after the experimentally induced ischemia of one of the hip joints. Ischemia was induced by increasing intra-articular pressure to 250 mmHg. All pigs showed ischemia of the femoral head epiphysis under hip joint tamponade followed by reperfusion to the same level as before joint tamponade. In two cases perfusion after removal of tamponade continued to be low. In dynamic MRI measurements increases in signal intensity were seen after intravenous infusion of Gd-DTPA, followed by a slow decrease in signal intensity. The signal-intensity curve during femoral head ischemia had a minor increase. Also the coefficient determined was a helpful indicator of femoral head ischemia. Femoral head blood flow as measured by microspheres fell significantly under joint tamponade. Early detection of this disturbed regional blood flow was possible using a dynamic MRI procedure. A biomathematical model resulted from the evaluation of the intervals of signal intensity over time which allows detection of bone blood flow changes at a very early stage. Using this new method earlier detection of femoral head necrosis may be possible. (orig.)

  2. 旋股外侧动脉降支侧支皮瓣修复下肢软组织缺损%CLINICAL RESULTS OF FLAP PEDICLED WITH COLLATERAL BRANCH OF DESCENDING RARUS OF LATERAL CIRCUMFLEX FEMORAL ARTERY FOR REPAIRING LOWER LIMB SOFT TISSUE DEFECTS

    Institute of Scientific and Technical Information of China (English)

    刘智伟; 余斌; 覃承诃; 罗吉伟; 胡岩君

    2011-01-01

    Objective To investigate the clinical results of the flap pedicled with collateral branch of descending rarus of lateral circumflex femoral artery with digital three-dimensional reconstruction technique for lower limb soft tissue defects. Methods Between March 2009 and January 2010, 7 patients with lower limb soft tissue defects were treated with free flap pedicled with collateral branch of descending rarus of lateral circumflex femoral artery. There were 6 males and 1 female with an age range from 6 to 51 years. They were injured by traffic accident (4 cases), or by object hit from height (3 cases). The locations were foot in 2 cases, ankle in 2 cases, and anterior tibia in 3 cases. The disease duration was 8 hours to 40 days (mean,20 days). All the cases complicated by exposure of tendons or bones. The areas of soft tissue defect ranged from 12 cm × 7 cm to 20 cm × 14 cm. Free flaps were transplanted at 4 to 16 days after symptomatic treatment. Before operation, all the flaps were designed with digital three-dimensional reconstruction technique. The size of flaps ranged from 15 cm × 9 cm to 22 cm × 16 cm.The donor sites were closed directly in all cases. Results All the flaps survived. The wounds and incisions at donor sites healed by first intention. All the patients were followed up 6 to 12 months. The texture, appearance, and function of the flaps were satisfactory, and no complication occurred. All the flaps had protective sensation, which could meet the requirement of the daily life. The function of ankle was satisfactory with normal walk; the extension was 19-22° and the flexion was 30-36°. No obvious scar formed at donor sites. Conclusion The flap pedicled with collateral branch of descending rarus of lateral circumflex femoral artery has reliable blood supply, easy operation, little influence on the donor site, and high success rate with digital three-dimensional reconstruction technique. It is an excellent option for repairing lower limb soft

  3. 体外治疗性超声辅助尿激酶在兔股动脉血栓溶栓治疗中的效果评价%Thrombolytic effect of ultrasound-assisted urokinase on femoral artery thrombus in rabbits

    Institute of Scientific and Technical Information of China (English)

    刘海芳; 仇星; 濮恬宁; 穆洁; 朱玉萍

    2015-01-01

    目的 评价体外治疗性超声辅助尿激酶对兔股动脉血栓溶栓的疗效.方法 将12只新西兰大耳白兔完全随机分为观察组和对照组,每组6只,采用三氯化铁外敷股动脉方法建立左侧股动脉急性血栓模型.模型建立4h后对照组静脉注射尿激酶30 000 U/kg,观察组在给予尿激酶的同时给予体外治疗性超声辐照(功率1.00 W/cm2),持续60 min.于治疗开始后60、90和120 min超声检测股动脉再通情况及血管内血流束宽度;病理检查血管超声热损伤情况.结果 所有动物均成功建立股动脉急性血栓模型.开始溶栓治疗后60、90和120 min,对照组分别有3、4和5只兔血管完全再通,观察组各时点6根血管均完全再通,2组比较差异有统计学意义(P<0.05).开始溶栓治疗后60、90和120 min,观察组血流束宽度均大于对照组[(0.63±0.10)比(0.08±0.12)、(0.73±0.08)比(0.20 ±0.20)、(0.91±0.15)比(0.27±0.27) mm],差异有统计学意义(均P<0.01).病理结果显示观察组管壁未发生由超声治疗引起的热损伤.结论 采用功率为1.00 W/cm2的体外治疗性辅助尿激酶溶解急性期血栓安全有效.%Objective To evaluate the thrombolytic effect of ultrasound-assisted urokinase on femoral artery thrombus in rabbits.Methods Totally 12 rabbits were randomly divided into observation group and control group (each n =6);the FeCl3 was applied externally on the left femoral arterial to establish the thrombosis model.Four hour after thrombosis,control group was given urokinase intravenously (30 000 U/kg) and observation group was given ultrasonic irradiation (power of 1.00 W/cm2) for 60 min in addition to the urokinase.The ultrasound was used to measure the recanalization and the width of blood flow 60,90 and 120 min after thrombolytic therapy started;the thermal damage of the vessel was observed under the microscopy.Results The thrombosis models were established successfully in all the animals.The femoral artery

  4. Evaluation of femoral artery elasticity in passive smokers and active smokers by E - tracking technology%血管回声跟踪技术评价主动与被动吸烟者股动脉弹性的研究

    Institute of Scientific and Technical Information of China (English)

    乞艳华; 郑转梅; 周琦; 雷晓莹

    2011-01-01

    目的 探讨血管回声跟踪(ET)技术评价主动吸烟者与被动吸烟者股动脉血管弹性功能的应用价值.方法 利用ET技术检测40例主动吸烟者、40例被动吸烟者、40例健康对照组的股动脉,通过内-中膜厚度(IMT)、僵硬度(β)、压力-应变弹性系数(Eρ)、动脉顺应性(AC)、脉搏波放大指数(AI)及脉搏波传导速度(PWVβ)评价动脉硬化程度.结果主动吸烟组AI、PWVβ高于被动吸烟组,差异有统计学意义(P<0.05);主动吸烟组、被动吸烟组β和Eρ均高于对照组,差异有统计学意义(P<0.05); 主动吸烟组、被动吸烟组AC均低于对照组,差异有统计学意义(P<0.01).结论 ET技术可早期发现被动吸烟者和主动吸烟者股动脉弹性功能的改变,测量结果精确,是一种无创、便捷的检查方法.%Objective To explore the application value of E - tracking technology (ET) in evaluating femoral artery elasticity in passive smokers and active smokers. Methods Forty active smokers, 40 passive smokers and 40 normal persons (the control group) were enrolled in this study. The arteriosclerosis degree was evaluated by (intima- media thickness) IMT,pressure- strain elastic modulus (Ep), stiffness parameters (β), arterial compliance (AC), pulse amplification index (Al),Pulse wave transmission speed(PWVβ). Results Al and PWVβ in active smoking group were higher than those in passive smoking group, while βand Eρ in active smoking group and passive smoking group were higher than those in normal control group (P <0.05), there was significant difference. AC was lower in passive and active smokers than that in normal control group,there was significant difference ( P < 0.01 ). Conclusion As a convenient and non - invasive method, ET can be used to access the vessel dysfunction of passive and active smokers accurately.

  5. Pedal arteries of monkeys, with special reference to the plantar metatarsal arteries.

    Directory of Open Access Journals (Sweden)

    Hinenoya,Hitoshi

    1987-12-01

    Full Text Available In the Japanese, Formosan and crab-eating monkeys, the dorsal metatarsal arteries and their lateral distal perforating branches were well developed and supplied, directly or via the catella plantaris distalis, the plantar digital arteries. In the black ape, the plantar digital arteries arose from the medial plantar artery. The plantar metatarsal arteries of these monkeys, including the black ape, arose from the catella plantaris proximalis or deep plantar arch and were classified into the superficial plantar metatarsal (sM, superficial plantar intermetatarsal (sI, deep plantar metatarsal (dM and deep plantar intermetatarsal (dI arteries in relation to the interosseous muscles and metatarsal bones. This classification largely coincides with that of the human hand and foot (Murakami, 1969, 1971 and the monkey hand (Nakai et al., 1987.

  6. Patient Satisfaction After Femoral Arterial Access Site Closure Using the ExoSeal{sup ®} Vascular Closure Device Compared to Manual Compression: A Prospective Intra-individual Comparative Study

    Energy Technology Data Exchange (ETDEWEB)

    Pieper, Claus Christian, E-mail: claus.christian.pieper@ukb.uni-bonn.de; Thomas, Daniel, E-mail: daniel.thomas@ukb.uni-bonn.de [University of Bonn, Department of Radiology (Germany); Nadal, Jennifer, E-mail: jennifer.nadal@ukb.uni-bonn.de [University of Bonn, Institute for Medical Biometry, Informatics and Epidemiology (Germany); Willinek, Winfried A., E-mail: w.willinek@bk-trier.de; Schild, Hans Heinz, E-mail: hans.schild@ukb.uni-bonn.de; Meyer, Carsten, E-mail: carsten.meyer@ukb.uni-bonn.de [University of Bonn, Department of Radiology (Germany)

    2016-01-15

    PurposeTo intra-individually compare discomfort levels and patient satisfaction after arterial access closure using the ExoSeal{sup ®} vascular closure device (VCD) and manual compression (MC) in a prospective study design.MethodsPatients undergoing two planned interventions from 07/2013 to 09/2014 could participate in the study. Access closure was performed with an ExoSeal{sup ®}-VCD in one and MC in the other intervention. Patients were clinically and sonographically examined and were given questionnaires 1 day after intervention [groin- and back-pain during bedrest (100-point visual analog scale; 0: no pain); comfortability of bedrest (10-point Likert scale, 1: comfortable), satisfaction with closure (10-point Likert scale, 1: very satisfied)]. Results were analyzed in a cross-over design.Results48 patients (29 male, median age 62.5 (32–88) years) were included. An ExoSeal{sup ®}-VCD was used first in 25 cases. As four of these subsequently refused MC as second intervention, data from 44 patients could be analyzed. All closures were technically successful (successful device deployment) without major complications. Groin- and back-pain after VCD-use/MC was 0 (0–15) vs. 10 (0–80) and 0 (0–75) vs. 25 (0–90), respectively (p < 0.0001). Bedrest after VCD-use was more comfortable than after MC [1 (range 1–7) vs. 6 (2–10); p < 0.0001]. Satisfaction with the closure procedure and with the intervention in general was higher after VCD-use compared to MC [1 (1–3) vs. 5 (2–10) and 1 (1–2) vs. 2 (1–4), respectively; p < 0.0001].ConclusionIntra-individual comparison showed pain levels and discomfort to be significantly lower after ExoSeal{sup ®} use compared to MC. VCD closure was associated with higher satisfaction both with the closure itself and with the intervention in general.

  7. Femoral Reconstruction Using External Fixation

    Directory of Open Access Journals (Sweden)

    Yevgeniy Palatnik

    2011-01-01

    Full Text Available Background. The use of an external fixator for the purpose of distraction osteogenesis has been applied to a wide range of orthopedic problems caused by such diverse etiologies as congenital disease, metabolic conditions, infections, traumatic injuries, and congenital short stature. The purpose of this study was to analyze our experience of utilizing this method in patients undergoing a variety of orthopedic procedures of the femur. Methods. We retrospectively reviewed our experience of using external fixation for femoral reconstruction. Three subgroups were defined based on the primary reconstruction goal lengthening, deformity correction, and repair of nonunion/bone defect. Factors such as leg length discrepancy (LLD, limb alignment, and external fixation time and complications were evaluated for the entire group and the 3 subgroups. Results. There was substantial improvement in the overall LLD, femoral length discrepancy, and limb alignment as measured by mechanical axis deviation (MAD and lateral distal femoral angle (LDFA for the entire group as well as the subgroups. Conclusions. The Ilizarov external fixator allows for decreased surgical exposure and preservation of blood supply to bone, avoidance of bone grafting and internal fixation, and simultaneous lengthening and deformity correction, making it a very useful technique for femoral reconstruction.

  8. Lower body lift with superficial fascial system suspension.

    Science.gov (United States)

    Lockwood, T

    1993-11-01

    Multiple body contour deformities of the trunk and thighs are commonly treated in separate stages to limit postoperative complications and disability. Recent advances in the surgical design of the medial thigh lift and the lateral thigh/buttock lift along with an understanding of the functional anatomy of the superficial fascial system have significantly improved results and decreased complications of trunk/thigh lifts. The enhanced safety of current trunk/thigh lifts has allowed new combinations to treat multiple body contour deformities in a single stage. Laxity of the entire lower trunk and thigh regions can be treated in one stage in selected patients. The lower body lift combines the transverse flank/thigh/buttock lift and the fascial anchoring medial thigh lift in one operation. In addition to the expected tightening of the flank, buttocks, and total thighs, this procedure results in a surprising degree of epigastric and hypogastric tightening of mild to moderate abdominal laxity without direct surgical undermining or umbilical transposition. Ten patients having the lower body lift alone or in combination with liposuction and other body contouring procedures were followed for 6 to 24 months. The primary indication for surgery is moderate to severe soft-tissue laxity of the lower trunk and thighs with minimal or mild residual fat deposits. Skin contour irregularities due to skin laxity (cellulite of laxity) or to postliposuction adhesions are frequently present and may be severe. Patients with significant fat deposits may be treated initially with liposuction 3 to 4 months earlier to become candidates for this procedure. Key technical elements of this procedure include (1) both supine and lateral decubitus positioning with the hip flexed and abducted to allow overcorrection, (2) appropriate direct surgical undermining through superficial fascial system zones of adherence in the superior thigh while avoiding the lymphatics of the femoral triangle, (3) more

  9. Arteriopatía periférica crónica inducida por cocaína Chronic peripheral arterial disease induced by cocaine

    Directory of Open Access Journals (Sweden)

    Sonia Pankl

    2012-02-01

    Full Text Available La trombosis periférica aguda inducida por cocaína ha sido descripta en la literatura, siendo una complicación poco común. Si bien existen comunicaciones que reflejan los efectos crónicos de la cocaína sobre el sistema arterial periférico, no hay casos publicados de tal complicación en ausencia de otros factores de riesgo. Se presenta el caso de una mujer de 22 años de edad con antecedentes de consumo de cocaína intranasal de 3 gramos por semana durante un año, que consultó por claudicación intermitente a los 200 metros asociada a dolor y parestesias en miembro inferior izquierdo de 2 meses de evolución. El ecodoppler arterial evidenció una estenosis mayor del 70% en la arteria femoral superficial izquierda. Se realizaron estudios complementarios descartando otras etiologías probables. Se inició tratamiento con ácido acetilsalicílico, cilostazol y ejercicio reglado, asociado a terapia de apoyo para mantenimiento del cese del consumo de cocaína, con buena respuesta. Se destaca la importancia de la difusión de información a los pacientes, dado que la mayoría de la población desconoce las complicaciones cardiovasculares de dicha adicción. Es indispensable indagar sobre el consumo de cocaína en pacientes jóvenes con arteriopatía sin factores de riesgo aparentes.Cocaine induced acute peripheral thrombosis, though a rare complication, has been described in the literature. Although there are reports describing the chronic effects of cocaine on the peripheral arterial system, there are no published cases of this complication when other risk factors are lacking. We report on a 22 year old female patient, with intranasal consumption of 3 grams of cocaine per week for a year, who consulted for intermittent claudication at 200 meters, associated to left lower limb pain and paresthesiae for the last two months. Arterial Doppler ultrasonography showed a stenosis greater than 70% in the superficial left femoral artery. Other

  10. Scanning electron microscopy of superficial white onychomycosis*

    Science.gov (United States)

    de Almeida Jr., Hiram Larangeira; Boabaid, Roberta Oliveira; Timm, Vitor; Silva, Ricardo Marques e; de Castro, Luis Antonio Suita

    2015-01-01

    Superficial white onychomycosis is characterized by opaque, friable, whitish superficial spots on the nail plate. We examined an affected halux nail of a 20-year-old male patient with scanning electron microscopy. The mycological examination isolated Trichophyton mentagrophytes. Abundant hyphae with the formation of arthrospores were found on the nail's surface, forming small fungal colonies. These findings showed the great capacity for dissemination of this form of onychomycosis. PMID:26560225

  11. Treatment of superficial mycoses: review - part II

    OpenAIRE

    2013-01-01

    Superficial fungal infections of the hair, skin and nails are a major cause of morbidity in the world. Choosing the right treatment is not always simple because of the possibility of drug interactions and side effects. The first part of the article discusses the main treatments for superficial mycoses - keratophytoses, dermatophytosis, candidiasis, with a practical approach to the most commonly-used topical and systemic drugs , referring also to their dosage and duration of use. Promising new...

  12. Treatment of superficial mycoses: review - part II*

    OpenAIRE

    2013-01-01

    Superficial fungal infections of the hair, skin and nails are a major cause of morbidity in the world. Choosing the right treatment is not always simple because of the possibility of drug interactions and side effects. The first part of the article discusses the main treatments for superficial mycoses - keratophytoses, dermatophytosis, candidiasis, with a practical approach to the most commonly-used topical and systemic drugs , referring also to their dosage and duration of use. Promising new...

  13. T1rho mapping of entire femoral cartilage using depth- and angle-dependent analysis

    Energy Technology Data Exchange (ETDEWEB)

    Nozaki, Taiki; Kaneko, Yasuhito; Yu, Hon J.; Yoshioka, Hiroshi [University of California Irvine, Department of Radiological Sciences, Orange, CA (United States); Kaneshiro, Kayleigh [University of California Irvine, School of Medicine, Irvine, CA (United States); Schwarzkopf, Ran [University of California Irvine, Department of Orthopedic Surgery, Irvine, CA (United States); Hara, Takeshi [Gifu University Graduate School of Medicine, Department of Intelligent Image Information, Division of Regeneration and Advanced Medical Sciences, Gifu (Japan)

    2016-06-15

    To create and evaluate normalized T1rho profiles of the entire femoral cartilage in healthy subjects with three-dimensional (3D) angle- and depth-dependent analysis. T1rho images of the knee from 20 healthy volunteers were acquired on a 3.0-T unit. Cartilage segmentation of the entire femur was performed slice-by-slice by a board-certified radiologist. The T1rho depth/angle-dependent profile was investigated by partitioning cartilage into superficial and deep layers, and angular segmentation in increments of 4 over the length of segmented cartilage. Average T1rho values were calculated with normalized T1rho profiles. Surface maps and 3D graphs were created. T1rho profiles have regional and depth variations, with no significant magic angle effect. Average T1rho values in the superficial layer of the femoral cartilage were higher than those in the deep layer in most locations (p < 0.05). T1rho values in the deep layer of the weight-bearing portions of the medial and lateral condyles were lower than those of the corresponding non-weight-bearing portions (p < 0.05). Surface maps and 3D graphs demonstrated that cartilage T1rho values were not homogeneous over the entire femur. Normalized T1rho profiles from the entire femoral cartilage will be useful for diagnosing local or early T1rho abnormalities and osteoarthritis in clinical applications. (orig.)

  14. Intra-arterial infusion of prostaglandin E1 in normal subjects and patients with peripheral arterial disease

    DEFF Research Database (Denmark)

    Nielsen, P E; Nielsen, S L; Holstein, P;

    1976-01-01

    Acute vasodilatation was produced by infusion of prostaglandin E1 (PGE1) in the femoral artery in 6 patients with occlusive arterial disease of the legs and in 3 normal subjects. The effect on blood flow and on blood pressure was measured at different segments of the leg with the strain gauge...

  15. Site-specific ultrasound reflection properties and superficial collagen content of bovine knee articular cartilage

    Energy Technology Data Exchange (ETDEWEB)

    Laasanen, Mikko S [Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Kuopio, POB 1777, FIN-70211 Kuopio (Finland); Department of Surgery, Division of Orthopaedics and Traumatology, Jyvaeskylae Central Hospital, Keskussairaalantie 19, FIN-40620 Jyvaeskylae (Finland); Saarakkala, Simo [Department of Nuclear Medicine, Etelae-Savo Hospital District, Mikkeli Central Hospital, Porrassalmenkatu 35-37, 50100 Mikkeli (Finland); Toeyraes, Juha [Department of Clinical Neurophysiology, Kuopio University Hospital and University of Kuopio, POB 1777, FIN-70211 Kuopio (Finland); Rieppo, Jarno [Department of Anatomy, University of Kuopio, POB 1627, FIN-70211 Kuopio (Finland); Jurvelin, Jukka S [Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Kuopio, POB 1777, FIN-70211 Kuopio (Finland); Department of Applied Physics, University of Kuopio, POB 1627, FIN-70211 Kuopio (Finland)

    2005-07-21

    Previous quantitative 2D-ultrasound imaging studies have demonstrated that the ultrasound reflection measurement of articular cartilage surface sensitively detects degradation of the collagen network, whereas digestion of cartilage proteoglycans has no significant effect on the ultrasound reflection. In this study, the first aim was to characterize the ability of quantitative 2D-ultrasound imaging to detect site-specific differences in ultrasound reflection and backscattering properties of cartilage surface and cartilage-bone interface at visually healthy bovine knee (n = 30). As a second aim, we studied factors controlling ultrasound reflection properties of an intact cartilage surface. The ultrasound reflection coefficient was determined in time (R) and frequency domains (IRC) at medial femoral condyle, lateral patello-femoral groove, medial tibial plateau and patella using a 20 MHz ultrasound imaging instrument. Furthermore, cartilage surface roughness was quantified by calculating the ultrasound roughness index (URI). The superficial collagen content of the cartilage was determined using a FT-IRIS-technique. A significant site-dependent variation was shown in cartilage thickness, ultrasound reflection parameters, URI and superficial collagen content. As compared to R and IRC, URI was a more sensitive parameter in detecting differences between the measurement sites. Ultrasound reflection parameters were not significantly related to superficial collagen content, whereas the correlation between R and URI was high. Ultrasound reflection at the cartilage-bone interface showed insignificant site-dependent variation. The current results suggest that ultrasound reflection from the intact cartilage surface is mainly dependent on the cartilage surface roughness and the collagen content has a less significant role.

  16. Applied anatomy of the superficial branch of the radial nerve.

    Science.gov (United States)

    Robson, A J; See, M S; Ellis, H

    2008-01-01

    The superficial branch of the radial nerve (SBRN) is highly vulnerable to trauma and iatrogenic injury. This study aimed to map the course of the SBRN in the context of surgical approaches and identify a safe area of incision for de Quervain's tenosynovitis. Twenty-five forearms were dissected. The SBRN emerged from under brachioradialis by a mean of 8.31 cm proximal to the radial styloid (RS), and remained radial to the dorsal tubercle of the radius by a mean of 1.49 cm. The nerve divided into a median of four branches. The first branch arose a mean of 4.92 cm proximal to the RS, traveling 0.49 cm radial to the first compartment of the extensor retinaculum, while the main nerve remained ulnar to it by 0.64 cm. All specimens had branches underlying the traditional transverse incision for de Quervain's release. A 2.5-cm longitudinal incision proximal from the RS avoided the SBRN in 17/25 cases (68%). In 20/25 specimens (80%), the SBRN underlay the cephalic vein. In 18/25 (72%), the radial artery was closely associated with a sensory nerve branch near the level of the RS (SBRN 12/25, lateral cutaneous nerve of the forearm (LCNF) 6/25.) A longitudinal incision in de Quervain's surgery may be preferable. Cannulation of the cephalic vein in the distal third of the forearm is best avoided. The close association between the radial artery and first branch of the SBRN or the LCNF may explain the pain often experienced during arterial puncture. Particular care should be taken during radial artery harvest to avoid nerve injury.

  17. Complications Associated With Femoral Cannulation During Minimally Invasive Cardiac Surgery.

    Science.gov (United States)

    Lamelas, Joseph; Williams, Roy F; Mawad, Maurice; LaPietra, Angelo

    2017-06-01

    Different types of cannulation techniques are available for minimally invasive cardiac surgery. At our institution, we favor a femoral platform for most minimally invasive cardiac procedures. Here, we review our results utilizing this cannulation approach. We retrospectively reviewed all minimally invasive valve surgeries that were performed at our institution between January 2009 and January 2015. Operative times, lengths of stay, postoperative complications, and mortality were analyzed. We identified 2,645 consecutive patients. The mean age was 69.7 ± 12.77 years, and 1,412 patients (53.4%) were male. Three hundred fifty-eight patients (13.5%) had a history of cerebrovascular accident, 422 (16%) had previous heart surgery, and 276 (10.4%) had a history of peripheral vascular disease. The procedures performed were isolated aortic valve replacements (42.1%), isolated mitral valve operations (40.6%), tricuspid valve repairs (0.57%), double valve surgery (15%), triple valve surgery (0.3%), and ascending aortic aneurysm resection with and without circulatory arrest (5%). Femoral cannulation and central cannulation were utilized in 2,400 patients (90.7%) and 244 patients (9.3%), respectively. The median aortic cross-clamp time and cardiopulmonary bypass time were 81 minutes (interquartile range, 65 to 105) and 113 minutes (interquartile range, 92 to 142), respectively. The median postoperative hospital length of stay was 6 days (interquartile range, 5 to 9). There were 31 cerebrovascular accidents (1.17%), no aortic dissections, two compartment syndromes, two femoral arterial pseudoaneurysms, and 174 (6.65%) groin wound seromas. The overall 30-day mortality was 57 patients (2.15%). Minimally invasive cardiac surgical procedures utilizing femoral cannulation techniques have a low risk of complications. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  18. Distal run-off vessel of descending branch of lateral femoral circumflex artery used for reconstruction of extremity defects with free anterolateral thigh flap%旋股外动脉降支远端血管在股前外侧游离皮瓣修复四肢创面中的应用

    Institute of Scientific and Technical Information of China (English)

    何晓清; 朱跃良; 徐永清; 梅良斌; 王毅; 范新宇; 董凯旋

    2015-01-01

    目的 探讨旋股外动脉降支远端血管在股前外侧游离皮瓣修复四肢创面中的应用价值.方法 回顾性分析2009年3月至2013年6月采用带旋股外动脉降支远端血管的股前外侧游离皮瓣修复的14例四肢组织缺损患者资料,男13例,女1例;平均年龄为34.6岁(8~ 57岁).组织缺损部位:足踝部8例,小腿部3例,手部3例.创面缺损面积为5.5cm×4.5cm~25.0cm×14.0 cm.降支远端血管以Flow-through皮瓣方式同时完成血管重建和创面覆盖4例,以Flow-through皮瓣方式保留受区血管连续性6例,以重组嵌合皮瓣方式串联第2足趾同时完成创面覆盖与食指再造1例,以串联横支穿支皮瓣完成足背大创面修复1例,术后血管危象探查中降支远端血管以备用血管发挥作用2例. 结果 14例患者降支远端血管的分离时间为3~7 min,平均4.6 min.降支远端血管平均长度为3.8 cm(1.5 ~6.0 cm).所有患者均未因降支远端血管的切取而出现相关并发症.14例患者术后获2~18个月(平均6.4个月)随访.所有患者皮瓣均完全成活,随访过程中无感染、坏死发生,质地、色泽均良好.8例足踝部缺损及3例小腿部缺损患者均恢复行走功能,足远端血供良好.3例手部缺损患者功能恢复良好. 结论 在股前外侧游离皮瓣修复四肢创面中旋股外动脉降支远端血管分离容易,切取后对供区无额外损伤,且可以根据不同手术目的保留适当长度,以Flow-through皮瓣、重组嵌合皮瓣及备用血管等方式发挥重要作用.%Objective To explore the value of the distal run-off vessel of the descending branch of the lateral circumflex femoral artery in reconstruction of extremity defects with free anterolateral thigh flap.Methods From March 2009 to June 2013,14 patients with extremity defects were repaired with free anterolateral thigh flap that carried the distal run-off vessel of the descending branch of the lateral circumflex femoral artery

  19. Radial Versus Femoral Access for Acute Coronary Syndromes.

    Science.gov (United States)

    Routledge, Helen; Sastry, Sanjay

    2015-12-01

    The feasibility and safety of transradial coronary intervention was demonstrated soon after the description of the transfemoral approach, despite which the use of the femoral artery still dominates in acute coronary syndrome intervention. The advantages of using the radial artery are virtual elimination of access site complications and an important reduction in bleeding, both of which are of utmost importance to the patient with myocardial infarction. Randomised controlled trials have now documented what seems inherent; that transradial intervention should bring with it an advantage in terms of morbidity and mortality in this cohort. The potential disadvantages in terms of speed of procedure and radiation exposure are negated by operator experience. Registries have illustrated that conversion on a large scale from the femoral to the transradial approach is safe and saves lives, most convincingly so in acute coronary syndrome intervention. This review discusses the potential benefits and risks of the alternative access sites in acute patients and explores how these are borne out in the published data.

  20. Arterial endothelial function measurement method and apparatus

    Energy Technology Data Exchange (ETDEWEB)

    Maltz, Jonathan S; Budinger, Thomas F

    2014-03-04

    A "relaxoscope" (100) detects the degree of arterial endothelial function. Impairment of arterial endothelial function is an early event in atherosclerosis and correlates with the major risk factors for cardiovascular disease. An artery (115), such as the brachial artery (BA) is measured for diameter before and after several minutes of either vasoconstriction or vasorelaxation. The change in arterial diameter is a measure of flow-mediated vasomodification (FMVM). The relaxoscope induces an artificial pulse (128) at a superficial radial artery (115) via a linear actuator (120). An ultrasonic Doppler stethoscope (130) detects this pulse 10-20 cm proximal to the point of pulse induction (125). The delay between pulse application and detection provides the pulse transit time (PTT). By measuring PTT before (160) and after arterial diameter change (170), FMVM may be measured based on the changes in PTT caused by changes in vessel caliber, smooth muscle tone and wall thickness.

  1. Risk of femoral hernia after inguinal herniorrhaphy

    DEFF Research Database (Denmark)

    Mikkelsen, T; Bay-Nielsen, M; Kehlet, H

    2002-01-01

    BACKGROUND: Small case series have suggested an increased risk of femoral hernia after previous inguinal herniorrhaphy, but no large-scale data with complete follow-up are available. METHODS: Data were extracted from the Danish Hernia Database covering the interval from 1 January 1998 to 1 July...... 2001, and included 34 849 groin hernia repairs. RESULTS: Of 1297 femoral hernia repairs, 71 patients had previously had an operation for inguinal hernia within the observation period. These 71 femoral hernias represented 7.9 per cent of all reoperations for groin hernia recorded in the database....... The median time to reoperation for a 'recurrent' femoral hernia after previous inguinal herniorrhaphy was 7 months, compared with 10 months for inguinal recurrences. The risk of developing a 'recurrent' femoral hernia after previous inguinal herniorrhaphy was 15 times higher than the rate of femoral hernia...

  2. Risk of femoral hernia after inguinal herniorrhaphy

    DEFF Research Database (Denmark)

    Mikkelsen, T; Bay-Nielsen, M; Kehlet, H

    2002-01-01

    BACKGROUND: Small case series have suggested an increased risk of femoral hernia after previous inguinal herniorrhaphy, but no large-scale data with complete follow-up are available. METHODS: Data were extracted from the Danish Hernia Database covering the interval from 1 January 1998 to 1 July...... 2001, and included 34 849 groin hernia repairs. RESULTS: Of 1297 femoral hernia repairs, 71 patients had previously had an operation for inguinal hernia within the observation period. These 71 femoral hernias represented 7.9 per cent of all reoperations for groin hernia recorded in the database....... The median time to reoperation for a 'recurrent' femoral hernia after previous inguinal herniorrhaphy was 7 months, compared with 10 months for inguinal recurrences. The risk of developing a 'recurrent' femoral hernia after previous inguinal herniorrhaphy was 15 times higher than the rate of femoral hernia...

  3. Differential effects of relaxin deficiency on vascular aging in arteries of male mice.

    Science.gov (United States)

    Jelinic, Maria; Tare, Marianne; Conrad, Kirk P; Parry, Laura J

    2015-08-01

    Exogenous treatment with the naturally occurring peptide relaxin increases arterial compliance and reduces vascular stiffness. In contrast, relaxin deficiency reduces the passive compliance of small renal arteries through geometric and compositional vascular remodeling. The role of endogenous relaxin on passive mechanical wall properties in other vascular beds is unknown. Importantly, no studies have investigated the effects of aging in arteries of relaxin-deficient mice. Therefore, we tested the hypothesis that mesenteric and femoral arteries stiffen with aging, and this is exacerbated with relaxin deficiency. Male wild-type (Rln (+/+)) and relaxin knockout (Rln (-/-)) mice were aged to 3, 6, 12, 18, and 23 months. Passive mechanical wall properties were assessed by pressure myography. In both genotypes, there was a significant increase in circumferential stiffening in mesenteric arteries with aging, whereas in the femoral artery, aging reduced volume compliance. This was associated with a reduced ability of the artery to lengthen with aging. The predominant phenotype observed in Rln (-/-) mice was reduced volume compliance in young mice in both mesenteric and femoral arteries. In summary, aging induces circumferential stiffening in mesenteric arteries and axial stiffening in femoral arteries. Passive mechanical wall properties of Rln (-/-) mouse arteries predominantly differ at younger ages compared with Rln (+/+) mice, suggesting that a lack of endogenous relaxin only has a minor effect on vascular aging.

  4. Relationship between antiphospholipid antibodies and progression of lower extremity arterial occlusive disease after lower extremity bypass operations.

    Science.gov (United States)

    Lam, E Y; Taylor, L M; Landry, G J; Porter, J M; Moneta, G L

    2001-05-01

    Antiphospholipid antibodies (APLs), which consist of anticardiolipin antibodies (ACLs) or lupus anticoagulant (LA), are associated with venous thrombosis, stroke, and cardiac events. Although they are present in many patients with lower extremity atherosclerotic occlusive disease (LEAOD), the relationship between APL and the progression of LEAOD has not been reported. A comparison of progression of LEAOD as determined with direct imaging studies in patients with and without APL forms the basis for this report. APL+ patients (immunoglobulin M [IgM] or IgA or IgG ACL > 3 SD units above control mean or positive LA) who underwent lower extremity bypass grafting between January 1990 and June 1999 (n = 79) were compared with an APL control group (n = 68). Members of the study and control groups were similar with respect to age, procedure, sex, length of follow-up, and multiple atherosclerosis risk factors. Progression of LEAOD was determined by comparing preoperative arteriograms with postoperative imaging studies (arteriograms or duplex scanning). External iliac, common femoral, superficial femoral and popliteal arteries were graded as or = 50% stenosis, or occluded. Posterior tibial and anterior tibial arteries were graded as patent or occluded. Progression was defined as any increase in stenosis category. The mean follow-up period was 31 months for APL+ and 35 months for APL- patients (P = not significant). Progression of LEAOD occurred in 58 (73%) of 79 APL+ patients and in 25 (37%) of 68 APL- patients (P operations was a significant independent risk factor for progression of LEAOD. We conclude that this patient group should be closely monitored in the postoperative period and appears ideally suited for prospective studies of therapies to modify LEAOD progression.

  5. Application of a three-dimensional microsurgical video system for a rat femoral vessel anastomosis

    Institute of Scientific and Technical Information of China (English)

    Liu Jianfeng; Chen Bin; Ni Yong; Zhan Yongqiang; Gao Haibin

    2014-01-01

    Background The operating microscopes have been applied to modern surgery for nearly a century.However,generations of microsurgeons have to flex their necks and fix their eyes on the eyepieces of a microscope continually that leads to physical and mental fatigue during a long operation.Stereoscopic three-dimensional (3D) media provides more ergonomic working environment,subsequently,resulting better performance in tasks and more accurate judgment.In this study,an alternative method of magnification was analyzed using a three-dimensional microsurgical video system and compared with the traditional method under microscopy to evaluate the availability and feasibility of a 3D microsurgical video system for microvascular anastomosis.Methods Forty Sprague-Dawley rats were randomly divided into four groups with each of 10.In 20 rats,10 femoral artery anastomoses with a conventional microscope (arterial microscope group) were compared with that of 10 femoral artery anastomoses with a 3D microsurgical video system (arterial 3D group).For the other 20 rats,10 femoral vein anastomoses using a conventional microscope (venous microscope group) were compared with that of 10 femoral vein anastomoses using a 3D microsurgical video system (venous 3D group).The arterial and venous microscope groups were considered to be the control groups.The arterial and venous 3D groups were the experimental groups.The examined criteria were as follows:anastomotic time,patency right after the procedure and 10 days later,number of sutures,vessel caliber,and pathological features.Results There were no differences between the operating equipment with respect to vessel caliber,anastomotic time,patency rate,number of sutures,and pathological changes in either the small arteries or veins.The average arterial anastomotic time of the arterial microscope group and arterial 3D group was 34.21 and 33.87 minutes,respectively (P >0.05).The average venous anastomotic time of the venous microscope group and

  6. Treatment of superficial mycoses: review - part II*

    Science.gov (United States)

    Dias, Maria Fernanda Reis Gavazzoni; Bernardes-Filho, Fred; Quaresma-Santos, Maria Victória Pinto; Amorim, Adriana Gutstein da Fonseca; Schechtman, Regina Casz; Azulay, David Rubem

    2013-01-01

    Superficial fungal infections of the hair, skin and nails are a major cause of morbidity in the world. Choosing the right treatment is not always simple because of the possibility of drug interactions and side effects. The first part of the article discusses the main treatments for superficial mycoses - keratophytoses, dermatophytosis, candidiasis, with a practical approach to the most commonly-used topical and systemic drugs , referring also to their dosage and duration of use. Promising new, antifungal therapeutic alternatives are also highlighted, as well as available options on the Brazilian and world markets. PMID:24474103

  7. Treatment of superficial mycoses: review. Part II.

    Science.gov (United States)

    Dias, Maria Fernanda Reis Gavazzoni; Bernardes-Filho, Fred; Quaresma-Santos, Maria Victória Pinto; Amorim, Adriana Gutstein da Fonseca; Schechtman, Regina Casz; Azulay, David Rubem

    2013-01-01

    Superficial fungal infections of the hair, skin and nails are a major cause of morbidity in the world. Choosing the right treatment is not always simple because of the possibility of drug interactions and side effects. The first part of the article discusses the main treatments for superficial mycoses - keratophytoses, dermatophytosis, candidiasis, with a practical approach to the most commonly-used topical and systemic drugs , referring also to their dosage and duration of use. Promising new, antifungal therapeutic alternatives are also highlighted, as well as available options on the Brazilian and world markets.

  8. Femoral rotation unpredictably affects radiographic anatomical lateral distal femoral angle measurements

    DEFF Research Database (Denmark)

    Miles, James Edward

    2016-01-01

    Objective: To describe the effects of internal and external femoral rotation on radiographic measurements of the anatomical lateral distal femoral angle (a-LDFA) using two methods for defining the anatomical proximal femoral axis (a-PFA). Methods: Digital radiographs were obtained of 14 right fem...

  9. Blood transfusion requirement in surgery for femoral artery aneurysms

    DEFF Research Database (Denmark)

    Levi, N; Schroeder, T V

    1997-01-01

    Audit of blood usage in various surgical specialities have shown that over-ordering of blood is widespread, causing unnecessary pressure on the transfusion facilities and giving growing concern over the expense of cross-matching blood. The aim of this study was to assess the blood transfusion...

  10. Blood transfusion requirement in surgery for femoral artery aneurysms

    DEFF Research Database (Denmark)

    Levi, N; Schroeder, T V

    1997-01-01

    Audit of blood usage in various surgical specialities have shown that over-ordering of blood is widespread, causing unnecessary pressure on the transfusion facilities and giving growing concern over the expense of cross-matching blood. The aim of this study was to assess the blood transfusion...

  11. Vascularization of the facial bones by facial artery: implications for full face allotransplantation

    OpenAIRE

    Rampazzo, Antonio

    2014-01-01

    Background-The maxillary artery is recognized as the main vascular supply of the facial bones; nonetheless clinical evidence supports a co-dominant role for the facial artery. This study explores the extent of the facial skeleton within a facial allograft that can be harvested based on the facial artery. Methods-Twenty-three cadaver heads were used in this study. In 12 heads, the right facial, superficial temporal and maxillary arteries were injected. In 1 head, facial artery angiography w...

  12. Adaptation of the Main Peripheral Artery and Vein to Long Term Confinement (MARS 500)

    OpenAIRE

    Philippe Arbeille; Romain Provost; Nicole Vincent; Andre Aubert

    2014-01-01

    PURPOSE: The objective was to check if 520 days in confinement (MARS 500), may affect the main peripheral arterial diameter and wall thickness and the main vein size. METHOD: Common carotid (CC) femoral artery (FA) portal vein (PV), jugular (JG), femoral vein (FV) and tibial vein were assessed during MARS 500 by echography, performed by the subjects. A hand free volumic echographic capture method and a delayed 3D reconstruction software developed by our lab were used for collecting and measur...

  13. Peripheral arterial blood pressure versus central crterial blood pressure monitoring in critically ill patients after Cardio-pulmonary Bypass.

    Science.gov (United States)

    Ahmad, Rana Altaf; Ahmad, Suhail; Naveed, Anjum; Baig, Mirza Ahmad Raza

    2017-01-01

    To determine the accuracy of peripheral (radial) arterial access as compared to central (femoral) arterial access for measurement of invasive blood pressure (IBP) in critically ill patients after cardiopulmonary bypass. Sixty patients (60) who required high inotropic/vasopressor support on weaning from cardio-pulmonary bypass and weaned off in 2(nd) attempt were included in this study. The duration of this study was from June 2015 to August 2016. Radial and femoral arterial access was achieved in all patients for simultaneous measurement of blood pressure. Arterial pressures were noted after 5, 15 and 30 minutes of weaning from cardiopulmonary bypass for both radial and femoral artery simultaneously. Mean age of study patients was 56.48±11.17 years. 85% patients were male. There was significant difference in systolic blood pressure, diastolic blood pressure and mean arterial pressures between the radial artery and femoral artery cannulation. Mean arterial pressures were significantly high in femoral artery as compared to the radial artery. The mean arterial pressures after five minutes of weaning using central access were 76.28±10.21 mmHg versus 64.15±6.76 mmHg in peripheral arterial access (p-value arterial pressures after 15 minutes of weaning from cardiopulmonary bypass 78.70±10.12 mmHg in central access versus 72.03±6.76 mmHg using peripheral arterial access (p-value arterial pressures were less marked as compared to the previous differences after 30 minutes of weaning from cardiopulmonary bypass as compared to the earlier readings (p-value 0.001). Peripheral arterial pressures are unreliable in critically ill patients after cardiopulmonary bypass receiving high dose of inotropic drugs. Central arterial access should be used in these patients to get accurate estimates of patients' blood pressure in early periods after cardiopulmonary bypass.

  14. Peripheral arterial blood pressure monitoring adequately tracks central arterial blood pressure in critically ill patients: an observational study.

    Science.gov (United States)

    Mignini, Mariano Alejandro; Piacentini, Enrique; Dubin, Arnaldo

    2006-01-01

    Invasive arterial blood pressure monitoring is a common practice in intensive care units (ICUs). Accuracy of invasive blood pressure monitoring is crucial in evaluating the cardiocirculatory system and adjusting drug therapy for hemodynamic support. However, the best site for catheter insertion is controversial. Lack of definitive information in critically ill patients makes it difficult to establish guidelines for daily practice in intensive care. We hypothesize that peripheral and central mean arterial blood pressures are interchangeable in critically ill patients. This is a prospective, observational study carried out in a surgical-medical ICU in a teaching hospital. Fifty-five critically ill patients with clinical indication of invasive arterial pressure monitoring were included in the study. No interventions were made. Simultaneous measurements were registered in central (femoral) and peripheral (radial) arteries. Bias and precision between both measurements were calculated with Bland-Altman analysis for the whole group. Bias and precision were compared between patients receiving high doses of vasoactive drugs (norepinephrine or epinephrine >0.1 microg/kg/minute or dopamine >10 microg/kg/minute) and those receiving low doses (norepinephrine or epinephrine arterial pressure was 3 +/- 4 mmHg higher than peripheral mean arterial pressure for the whole population and there were no differences between groups (3 +/- 4 mmHg for both groups). Measurement of mean arterial blood pressure in radial or femoral arteries is clinically interchangeable. It is not mandatory to cannulate the femoral artery, even in critically ill patients receiving high doses of vasoactive drugs.

  15. PERSISTENT MEDIAN ARTERY ASSOCIATED WITH SUPERFICIA L RADIAL ARTERY AT THE WRIST- A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Jayasabarinathan

    2013-02-01

    Full Text Available ABSTRACT: Vascular variations are usually the result of deve lopmental anomaly during the formation of blood vessels in any respective part of the body. In this case a rare unilateral variation was found on the left upper limb during rou tine dissection in the Department of Anatomy. Brachial artery divided into radial artery and a common trunk. The common trunk in turn divided into ulnar, median and common inteross eous artery. The median artery was palmar type, had two proper palmar digital branches in t he palm. The radial artery had normal course in the forearm till the junction between upper two third and lower one third where it turned dorsally and reached the anatomical snuff bo x and ran superficial to the abductor pollicis longus, extensor carpi radialis brevis and extensor carpi radialis longus along the cephalic vein medially and superficial branch of radial nerve late rally. The median artery, arose from the common trunk, had pierced the median nerve about 4cm from its origin then ran along the median nerve in the forearm thereby reached the palm where it gave off two common palmar digital branches but did not anastomose with the ul nar artery hence formed incomplete superficial palmar arch. But on the right side no suc h variations found. These vascular variations have been studied in detail and their cl inical implications and embryological significance are emphasized.

  16. DISCOVER: Dutch Iliac Stent trial: COVERed balloon-expandable versus uncovered balloon-expandable stents in the common iliac artery: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Bekken Joost A

    2012-11-01

    endovascular dilatation or revascularization of the common iliac artery, followed by placement of one or more uncovered balloon-expandable stents. The study group will undergo the same treatment, however one or more PTFE-covered balloon-expandable stents will be placed. When necessary, the aorta, external iliac artery, common femoral artery, superficial femoral artery and deep femoral artery will be treated, using the standard treatment. The primary endpoint is absence of binary restenosis rate. Secondary endpoints are reocclusion rate, target-lesion revascularization rate, clinical success, procedural success, hemodynamic success, major amputation rate, complication rate and mortality rate. Main study parameters are age, gender, relevant co-morbidity, and several patient, disease and procedure-related parameters. Trial registration Dutch Trial Register, NTR3381.

  17. Femoral head blood flow in long-term steroid therapy: study of rabbit model

    Energy Technology Data Exchange (ETDEWEB)

    Wang, G.J.; Hubbard, S.L.; Reger, S.I.; Miller, E.D.; Stamp, W.G.

    1983-12-01

    Using a rabbit model, previous studies showed steroid-induced hyperlipidemia with subsequent fatty embolization of the subchondral arteries and hypertrophy of the marrow fat cells, followed by elevation of femoral head pressure from the normal level of 25 cm to nearly 60 cm H2O after eight weeks of treatment. This has led us to believe that pressure changes lead to decreased blood flow in the femoral head. In our study of 22 New Zealand white adult rabbits, weighing an average of 4.0 kg, 14 received a weekly dose of 12.45 mg of methylprednisolone (Depo-Medrol), and eight served as control. Femoral head blood flow was established using the radioactive microsphere technique. Control and cortisone-treated rabbits had femoral head blood flow measured 6, 8 and 10 weeks after treatment. The average blood flow in the control femoral heads averaged 0.2039 +/- 0.076 ml/min/gm, with no difference in the left side and the right side. In the treated group, the average blood flow at ten weeks was 0.162 +/- 0.039 ml/min/gm on the right and 0.164 +/- 0.037 ml/min/gm on the left, which was significantly different. This is parallel to unpredictable clinical findings in human beings.

  18. Origins, distributions, and ramifications of the femoral nerves in giant anteater (Myrmecophaga tridactyla Linnaeus, 1758

    Directory of Open Access Journals (Sweden)

    Roseâmely Angélica de Carvalho-Barros

    2013-11-01

    Full Text Available The study of nerves making up the lumbosacral plexus is extremely important, because it relates the various evolutionary aspects of animals’ posture and locomotion. Taking into account that the femoral nerve is the largest one in the cranial part of the lumbosacral plexus, one aimed to describe the origins, distributions, and ramifications of femoral nerves in giant anteater (Myrmecophaga tridactyla, comparing them to the literature describing domestic and wild animals, in order to establish correlations of morphological similarities and provide the related areas with means. One used three specimens, prepared through an injection of 10% aqueous formaldehyde solution via femoral artery, for their conservation and posterior dissection. The origins in the right and left antimeres took place in the ventral braches of lumbar spinal nerves 1, 2, and 3. The distributions and ramifications were observed for the major and minor psoas, lateral and medial iliac, pectineus, adductor magnus, sartorius, and femoral quadriceps muscles. Having the origins of the M. tridactyla femoral nerves as a basis, a reframing was observed due to the variance in the number of lumbar vertebrae (L1, L2, and L3. However, a partial morphological similarity was kept with regard to the distributions and ramifications, when compared to the domestic and wild animals taken into account in this study.

  19. Superficial Urothelial Cancer in the Prostatic Urethra

    Directory of Open Access Journals (Sweden)

    Ziya Kirkali

    2006-01-01

    Full Text Available Transitional cell carcinoma (TCC is a multifocal disease of the urinary tract that can also involve the prostatic urethra (PU. The exact incidence of superficial involvement of the PU in patients with bladder TCC is not well known. Bladder TCC may involve the prostate in 12—40% of the patients and the degree of involvement can include urethral mucosa, ducts, acini, and stroma of the gland, which has been shown to affect the outcome. Risk factors for superficial urothelial cancer in the PU are high-grade, multifocal bladder TCC and presence of carcinoma in situ (CIS in the bladder. While visible tumors are easy to detect and resect, controversy still exists regarding the optimal technique to identify prostatic involvement by TCC. Prostatic urethral sampling by a transurethral resection biopsy or a cold-cup biopsy, particularly in the high-risk group of bladder cancer patients, has been recommended for detecting prostatic urethral involvement. Management of superficial prostatic involvement by TCC is also unclear. Currently, there is increasing recognition of the value of conservative treatment options with intravesical agents when there is superficial involvement of the PU. Particularly, intravesical bacillus Calmette-Guèrin (BCG seems to be an effective treatment alternative in the management of superficial involvement of the PU by TCC. Close follow-up by cystoscopy and PU biopsy at 3-month intervals, particularly in intermediate and high-risk patients who respond to intravesical therapy and in whom cystectomy is appropriate, is recommended in order to detect persistent tumor, recurrences, or progression.

  20. Superficial urothelial cancer in the prostatic urethra.

    Science.gov (United States)

    Kirkali, Ziya; Canda, A Erdem

    2006-02-28

    Transitional cell carcinoma (TCC) is a multifocal disease of the urinary tract that can also involve the prostatic urethra (PU). The exact incidence of superficial involvement of the PU in patients with bladder TCC is not well known. Bladder TCC may involve the prostate in 12-40% of the patients and the degree of involvement can include urethral mucosa, ducts, acini, and stroma of the gland, which has been shown to affect the outcome. Risk factors for superficial urothelial cancer in the PU are high-grade, multifocal bladder TCC and presence of carcinoma in situ (CIS) in the bladder. While visible tumors are easy to detect and resect, controversy still exists regarding the optimal technique to identify prostatic involvement by TCC. Prostatic urethral sampling by a transurethral resection biopsy or a cold-cup biopsy, particularly in the high-risk group of bladder cancer patients, has been recommended for detecting prostatic urethral involvement. Management of superficial prostatic involvement by TCC is also unclear. Currently, there is increasing recognition of the value of conservative treatment options with intravesical agents when there is superficial involvement of the PU. Particularly, intravesical bacillus Calmette-Guèrin (BCG) seems to be an effective treatment alternative in the management of superficial involvement of the PU by TCC. Close follow-up by cystoscopy and PU biopsy at 3-month intervals, particularly in intermediate and high-risk patients who respond to intravesical therapy and in whom cystectomy is appropriate, is recommended in order to detect persistent tumor, recurrences, or progression.

  1. Osteonecrosis of the femoral head: diagnosis and classification systems

    National Research Council Canada - National Science Library

    Choi, Ho-Rim; Steinberg, Marvin E; Y. Cheng, Edward

    2015-01-01

    Osteonecrosis of femoral head is a rare but disabling condition that usually results in progressive femoral head collapse and secondary arthritis necessitating total hip arthroplasty if not treated...

  2. The femoral sulcus in total knee arthroplasty.

    Science.gov (United States)

    Lingaraj, Krishna; Bartlett, John

    2009-05-01

    The position of the femoral sulcus relative to the midline of the distal femoral resection in total knee arthroplasty (TKA) was studied to determine if centralized placement of the femoral component on the distal femur was justified in terms of aligning the prosthetic sulcus with the native femoral sulcus. The location of the femoral sulcus was studied in 112 consecutive patients undergoing TKA. The mean sulcus position was 0.7 mm lateral to the midline of the distal femoral resection (SD 1.4, 95% CI, 0.5-1.0 mm). However, the variation in sulcus positions ranged from 4 mm medial to 4 mm lateral to the midline. The mean sulcus position in valgus knees was 1.0 mm lateral to the midline (SD 1.8), and that in varus knees was 0.7 mm lateral to the midline (SD 1.2) (P = 0.501). It appears prudent to centre the femoral component on the native sulcus rather than the midline of the distal femoral resection, so as to ensure accurate alignment of the prosthetic sulcus with the native sulcus and to encourage normal patella tracking.

  3. Femoral revision surgery with impaction bone grafting

    NARCIS (Netherlands)

    B.L.E.F. ten Have (Bas); R.W. Brouwer (Reinoud); F.C. van Biezen (Frans); J.A.N. Verhaar (Jan)

    2012-01-01

    textabstractThe purpose of this prospective study was to evaluate the long-term clinical and radiological outcomes of revision of the femoral component of a total hip replacement using impaction bone grafting. Femoral revision with an impacted allograft was performed on 29 patients (31 hips). In all

  4. Classification of subtrochanteric femoral fractures.

    Science.gov (United States)

    Loizou, C L; McNamara, I; Ahmed, K; Pryor, G A; Parker, M J

    2010-07-01

    A review of the literature identified 15 different classification methods for subtrochanteric femoral fractures. Only eight of those classifications defined the area of bone, which constituted a subtrochanteric fracture. The actual length of femur defined as the subtrochanteric zone varied from 3 cm up to the level of the femoral isthmus. There was no agreement between the different classifications regarding the proximal and distal border or for those fractures, which traverse anatomical boundaries. In the various classifications, fractures were subdivided into 2-15 subgroups. The majority of the identified studies were unable to find the classifications useful in either determining treatment or predicting the outcome after treatment. We subdivided subtrochanteric fractures into three types based on the degree of fracture comminution. We examined the inter- and intra-observer agreement of our recommended classification. One orthopaedic consultant, one specialist hip fracture surgeon, two trainee registrar orthopaedic surgeons and one specialty trainee in orthopaedics, on two different occasions, 8 weeks apart, independently classified the radiographs of 20 patients with a subtrochanteric fracture. The mean kappa value for inter- and intra-observer variation was 0.71 and 0.79, respectively, with both showing substantial agreement and, therefore, this simpler classification is recommended. Based on the review of previous classification methods, we also recommend that the subtrochanteric zone be defined as the one in which the fracture line crossing the femur is predominantly within the area of bone extending 5 cm below the lower border of the lesser trochanter.

  5. Relaxation response in femoral angiography.

    Science.gov (United States)

    Mandle, C L; Domar, A D; Harrington, D P; Leserman, J; Bozadjian, E M; Friedman, R; Benson, H

    1990-03-01

    Immediately before they underwent femoral angiography, 45 patients were given one of three types of audiotapes: a relaxation response tape recorded for this study, a tape of contemporary instrumental music, or a blank tape. All patients were instructed to listen to their audiotape during the entire angiographic procedure. Each audiotape was played through earphones. Radiologists were not told the group assignment or tape contents. The patients given the audiotape with instructions to elicit the relaxation response (n = 15) experienced significantly less anxiety (P less than .05) and pain (P less than .001) during the procedure, were observed by radiology nurses to exhibit significantly less pain (P less than .001) and anxiety (P less than .001), and requested significantly less fentanyl citrate (P less than .01) and diazepam (P less than .01) than patients given either the music (n = 14) or the blank (n = 16) control audiotapes. Elicitation of the relaxation response is a simple, inexpensive, efficacious, and practical method to reduce pain, anxiety, and medication during femoral angiography and may be useful in other invasive procedures.

  6. Incarcerated Femoral Hernia Containing Ipsilateral Fallopian Tube

    Directory of Open Access Journals (Sweden)

    Stefanos Atmatzidis

    2010-01-01

    Full Text Available Femoral hernias are more common in women and lead to a substantial higher rate for an emergency operation, due to strangulation. Incarcerated femoral hernia with fallopian tube as a content is an extremely rare condition. A 20-year-old woman presented to the emergency department complaining of a 6-day right groin swelling, which became painful and tender to palpation during the last 48 hours. Preoperative ultrasonography detected an oedematous hernia sac, above the femoral vessels, suggesting the presence of an incarcerated femoral hernia. The patient eventually underwent emergency surgery and the diagnosis of a strangulated femoral hernia sac, containing fallopian tube, was established. No resection of the uterine tube was performed and the hernia was repaired with polypropylene plug. The postoperative period was uneventful and the woman was discharged on the second postoperative day.

  7. Flash fluorescence with indocyanine green videoangiography to identify the recipient artery for bypass with distal middle cerebral artery aneurysms: operative technique.

    Science.gov (United States)

    Rodríguez-Hernández, Ana; Lawton, Michael T

    2012-06-01

    Distal middle cerebral artery (MCA) aneurysms frequently have nonsaccular morphology that necessitates trapping and bypass. Bypasses can be difficult because efferent arteries lie deep in the opercular cleft and may not be easily identifiable. We introduce the "flash fluorescence" technique, which uses videoangiography with indocyanine green (ICG) dye to identify an appropriate recipient artery on the cortical surface for the bypass, enabling a more superficial and easier anastomosis. Flash fluorescence requires 3 steps: (1) temporary clip occlusion of the involved afferent artery; (2) videoangiography demonstrating fluorescence in uninvolved arteries on the cortical surface; and (3) removal of the temporary clip with flash fluorescence in the involved efferent arteries on the cortical surface, thereby identifying a recipient. Alternatively, temporary clips can occlude uninvolved arteries, and videoangiography will demonstrate initial fluorescence in efferent arteries during temporary occlusion and flash fluorescence in uninvolved arteries during reperfusion. From a consecutive series of 604 MCA aneurysms treated microsurgically, 22 (3.6%) were distal aneurysms and 11 required a bypass. The flash fluorescence technique was used in 3 patients to select the recipient artery for 2 superficial temporal artery-to-MCA bypasses and 1 MCA-MCA bypass. The correct recipient was selected in all cases. The flash fluorescence technique provides quick, reliable localization of an appropriate recipient artery for bypass when revascularization is needed for a distal MCA aneurysm. This technique eliminates the need for extensive dissection of the efferent artery and enables a superficial recipient site that makes the anastomosis safer, faster, and less demanding.

  8. Femoral access in 100 consecutive subarachnoid hemorrhage patients: the "craniotomy" of endovascular neurosurgery

    Directory of Open Access Journals (Sweden)

    Huang Judy

    2010-11-01

    Full Text Available Abstract Background Femoral access is a fundamental element of catheter-based cerebral angiography. Knowledge of location of the common femoral artery (CFA bifurcation is important as the risk of retroperitoneal bleeding is increased if the puncture is superior to the inguinal ligament and there is an increased risk of thrombosis and arteriovenous fistula formation if the puncture is distal into branch vessels. We sought to characterize the location of the CFA bifurcation along with the presence of significant atherosclerosis or iliac tortuosity in a contemporary series of subarachnoid hemorrhage (SAH patients. Findings The records of a prospective single-center aneurysm database were reviewed to identify 100 consecutive SAH patients. Using an oblique femoral arteriogram, the presence of significant atherosclerosis, iliac tortuosity, and the CFA bifurcation were assessed. The CFA bifurcation was graded according to its position with respect to the femoral head: below (grade 1, lower half (grade 2, and above the upper half (grade 3. We found a CFA bifurcation grade 1 in 50 patients (50%, mean age 51.2 years, grade 2 in 40 patients (40%, mean age 55.5 years, and grade 3 in 10 patients (10%, mean age 58.2 years. Whereas 30 of 90 patients with CFA grades I or II were male (33%, only 10% with grade 3 were male (1 of 10, p = 0.12. Mean age for significant atherosclerosis was 65.5 +/- 2.6 years versus 50.9 +/- 1.6 years (p Conclusions Although a requisite element of endovascular treatment in SAH patients, femoral access can be complicated by a high common femoral artery bifurcation and the presence of atherosclerotic disease and/or iliac artery tortuosity. In this study, we found a grade 3 (above the femoral head CFA bifurcation in 10% patients, with 90% of these patients being female. We also found the presence of atherosclerotic disease and iliac tortuosity to be significantly more likely in patients older than 65 years of age.

  9. Bilateral popliteal artery entrapment syndrome: case report Síndrome do aprisionamento da artéria poplítea bilateral: relato de caso

    Directory of Open Access Journals (Sweden)

    Fabricio Mascarenhas de Oliveira

    2008-06-01

    Full Text Available Popliteal artery entrapment syndrome occurs due to an extrinsic compression of the popliteal vessels that results in vascular damage. It is one of the most frequent causes of intermittent claudication in young patients. The authors describe a case of bilateral syndrome by anomalous position of the gastrocnemius muscle, with abnormal slip of its medial head (Rich's type III. During the operation the occluded right side was reconstructed by autologous saphenous vein bypass from femoral superficial to peroneal artery and on the left side the slip muscle was transected by posterior approach. Popliteal artery entrapment syndrome should be treated by surgery despite the degree of symptoms. Surgical treatment technique has released the vessel by extracting the muscle that caused entrapment, and reconstructing the narrow lumen bypass grafting.A síndrome do aprisionamento da artéria poplítea ocorre em função de compressão extrínseca dos vasos poplíteos, que resulta em lesão vascular. Trata-se de uma das causas mais freqüentes de claudicação intermitente em pacientes jovens. Os autores descrevem um caso de síndrome bilateral devida à posição anômala do músculo gastrocnêmio, com deslizamento de sua cabeça média (tipo III da classificação de Rich. Durante a cirurgia, o lado direito ocluído foi reconstruído por derivação da veia safena autóloga da artéria superficial femoral para a artéria peroneal e, do lado esquerdo, o músculo que sofreu o deslizamento foi secionado através de via posterior. A síndrome do aprisionamento da artéria poplítea deve ser tratada por cirurgia, independente do grau dos sintomas. A técnica de tratamento cirúrgico liberou o vaso, extraindo o músculo que causava o aprisionamento e reconstruindo o lúmen estreito por derivação.

  10. Variations of femoral condyle shape.

    Science.gov (United States)

    Biscević, Mirza; Hebibović, Mujo; Smrke, Dragica

    2005-12-01

    The aim of this study is to mathematically approximate the shape of the femoral articulating line and compare radiuses of condylar curves within and between males and females. Ten male and ten female participants were included in the study. Radiuses of medial and lateral condylar curves were calculated from the side view knee X-ray by original mathematical equation. Average radiuses of condylar curves were between 4.5 and 1.7 cm medially, and between 3.2 and 1.8 cm laterally, for 0 degrees and 90 degrees flexion contact point respectively. Males had longer curve radiuses of both condyles (p knee geometry, and other ellipsoidal structures in human body, like wrist, scull segments, dental arches, etc.

  11. Tension free femoral hernia repair with plug

    Institute of Scientific and Technical Information of China (English)

    Milivoje Vukovi; Neboja Moljevi; Sinia Crnogorac

    2013-01-01

    Objective: To investigate the conventional technique involves treatment of femoral hernia an approximation inguinal ligament to pectineal ligament. In technique which uses mesh closure for femoral canal without tissue tension. Method: A prospective study from January 01. 2007-May 30. 2009. We analyzed 1 042 patients with inguinal hernia, of which there were 83 patients with 86 femoral hernia. Result: Femoral hernias were present in 7.96% of cases. Males were 13 (15.66%) and 70 women (84.34%). The gender distribution of men: women is 1:5.38. Urgent underwent 69 (83%), and the 14 election (17%) patients. Average age was 63 years, the youngest patient was a 24 and the oldest 86 years. Ratio of right: left hernias was 3.4:1. With bilateral femoral hernias was 3.61% of cases. In 7 patients (8.43%) underwent femoral hernia repair with 9 Prolene plug. Conclusions: The technique of closing the femoral canal with plug a simple. The plug is made from monofilament material and is easily formed. This technique allows the reduction of recurrence and can be used safely, quickly and easily in elective and emergency situations.

  12. What factors control superficial lava dome explosivity?

    Science.gov (United States)

    Boudon, Georges; Balcone-Boissard, Hélène; Villemant, Benoît; Morgan, Daniel J.

    2015-09-01

    Dome-forming eruption is a frequent eruptive style and a major hazard on numerous volcanoes worldwide. Lava domes are built by slow extrusion of degassed, viscous magma and may be destroyed by gravitational collapse or explosion. The triggering of lava dome explosions is poorly understood: here we propose a new model of superficial lava-dome explosivity based upon a textural and geochemical study (vesicularity, microcrystallinity, cristobalite distribution, residual water contents, crystal transit times) of clasts produced by key eruptions. Superficial explosion of a growing lava dome may be promoted through porosity reduction caused by both vesicle flattening due to gas escape and syn-eruptive cristobalite precipitation. Both processes generate an impermeable and rigid carapace allowing overpressurisation of the inner parts of the lava dome by the rapid input of vesiculated magma batches. The relative thickness of the cristobalite-rich carapace is an inverse function of the external lava dome surface area. Explosive activity is thus more likely to occur at the onset of lava dome extrusion, in agreement with observations, as the likelihood of superficial lava dome explosions depends inversely on lava dome volume. This new result is of interest for the whole volcanological community and for risk management.

  13. HISTOPATHOLOGY OF MARGINAL SUPERFICIAL PERIODONTIUM AT MENOPAUSE

    Directory of Open Access Journals (Sweden)

    A. Georgescu

    2012-03-01

    Full Text Available Premises: Sexual hormones may affect the general health condition of women, as early as puberty, continuing during pregnancy and also after menopause. Variations of the hormonal levels may cause different – either local or general – pathological modifications. Sexual hormones may also affect periodontal status, favourizing gingival inflammations and reducing periodontal resistance to the action of the bacterial plaque. Scope: Establishment of the correlations between the debut or the manifestation of menopause and the modifications produced in the superficial periodontium. Materials and method: Clinical and paraclinical investigations were performed on female patients with ages between 45 and 66 years, involving macroscopic, microscopic and radiological recording of the aspect of the superificial periodontium (gingiva. Results: Analysis of the histological sections evidenced atrophic and involutive modifications in the marginal superficial periodontium of female patients at menopause. Conclusions: Sexual hormones intervene