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The Journal of Thoracic and... Sep 2019
Topics: Allografts; Femoral Vein; Heart Ventricles; Norwood Procedures; Pulmonary Artery
PubMed: 31204138
DOI: 10.1016/j.jtcvs.2019.03.129 -
European Journal of Vascular and... Oct 2015The May-Husni procedure is a rarely used saphenofemoral venous bypass because of the small number of patients with post-thrombotic segmental femoral vein obstruction... (Review)
Review
OBJECTIVES
The May-Husni procedure is a rarely used saphenofemoral venous bypass because of the small number of patients with post-thrombotic segmental femoral vein obstruction alone and the lack of validated selection criteria. There are only a few institutional series reporting the use of this technique. The purpose of this report is to present the author's experience and critically review the literature.
METHODS
Within a 13 year period 12 patients with venous claudication, skin pigmentation, and severe pain and swelling of their legs underwent the May-Husni procedure. Their median age was 57 years (41-69 years). Imaging showed segmental venous obstruction of the femoral vein in all patients and poor or no inflow from the deep femoral vein. Two patients were lost to follow up and the remaining 10 patients were reviewed with a median follow up of 60 months (26-72 months).
RESULTS
The saphenopopliteal bypass remained patent in all patients at follow up. The development of reflux of the saphenous conduit in four patients did not affect the clinical improvement. Venous claudication resolved, hyper-pigmentation improved, and pain was relieved in all patients. Recanalization of the femoral vein 3 years following thrombosis was followed by recurrence of the post-thrombotic symptoms in two patients.
CONCLUSIONS
These results indicate that a highly selected subgroup of patients with severe symptomatic post-thrombotic syndrome secondary to chronic segmental obstruction of the femoral vein do well after the May-Husni procedure. In order to refine the criteria for the selection of patients who may benefit from this operation, there is a need for more studies that use a combination of hemodynamic and validated scales that diagnose and grade the severity of post-thrombotic syndrome.
Topics: Adult; Aged; Blood Vessel Prosthesis Implantation; Constriction, Pathologic; Female; Femoral Vein; Humans; Intermittent Claudication; Male; Middle Aged; Phlebography; Popliteal Vein; Postthrombotic Syndrome; Recurrence; Retrospective Studies; Saphenous Vein; Time Factors; Treatment Outcome; Ultrasonography, Doppler, Duplex; Vascular Patency; Venous Thrombosis
PubMed: 26238309
DOI: 10.1016/j.ejvs.2015.05.010 -
The Journal of Thoracic and... Oct 2018
Topics: Femoral Vein; Mammary Arteries; Saphenous Vein
PubMed: 29934007
DOI: 10.1016/j.jtcvs.2018.05.015 -
Medicina (Kaunas, Lithuania) Feb 2022: We aimed to analyze the morphology of the common femoral artery (CFA) and common femoral vein (CFV) and the anatomical relationship between the two blood vessels, and...
: We aimed to analyze the morphology of the common femoral artery (CFA) and common femoral vein (CFV) and the anatomical relationship between the two blood vessels, and to investigate the factors that influence the size of these blood vessels. : This retrospective study included 584 patients who underwent abdominal and pelvic computed tomography from 1 February to 28 February 2021. We measured the vessels at three regions on both lower extremities (inguinal ligament, distal vessel bifurcation, midpoint) and analyzed and classified the degree of overlap between the CFA and CFV into three types, as well as the factors affecting vessel size. : After comparing the femoral vessels according to location, it was confirmed that the CFA and CFV were larger distally than proximally on both sides ( < 0.001). The degree of overlap increased distally ( < 0.001) but was less at the middle ( < 0.001) and distal ( = 0.011) regions on the right side. It was found that the size of CFA and CFV were related to age, sex, and body mass index (BMI) and that malignancy also affects the CFA size. : The morphology of the CFA and CFV was conical and increased distally. The degree of overlap between the two blood vessels also increased distally but was less on the right than on the left. Age, sex, and BMI are significant factors affecting the sizes of the CFA and CFV, and malignancy is associated with the CFA size.
Topics: Body Mass Index; Femoral Artery; Femoral Vein; Humans; Retrospective Studies; Tomography, X-Ray Computed
PubMed: 35208648
DOI: 10.3390/medicina58020325 -
Journal of Anatomy Oct 2011Although deep venous insufficiency is common and important, the anatomy of deep vein valves is poorly understood. The aim of this study was to investigate the location,... (Review)
Review
Although deep venous insufficiency is common and important, the anatomy of deep vein valves is poorly understood. The aim of this study was to investigate the location, number and consistency of venous valves in the femoral and popliteal veins in normal subjects. A detailed literature search of PubMed was performed. Abstracts and selected full text articles were scrutinised and relevant studies published between 1949 and 2010 reporting anatomical details of deep vein valves were included. From 7470 articles identified by the initial search strategy, nine studies with a total of 476 legs were included in this review. All studies were cadaveric and subjects ranged from stillborn fetuses to 103 years of age. Studies suggested that femoral veins contain between one and six valves, and popliteal veins contain between zero and four valves. Deep vein valves were consistently located in the common femoral vein (within 5 cm of the inguinal ligament), the femoral vein (within 3 cm of the deep femoral vein tributary) and in the popliteal vein near the adductor hiatus. Valves are consistently located at specific locations in the deep veins of the leg, although there is often significant variability between subjects. Further anatomical and functional studies using new imaging modalities available should target these areas to identify whether certain valves play a more important role in venous disease. This may guide us in the development of new treatment options for patients with deep venous disease.
Topics: Femoral Vein; Humans; Popliteal Vein; Venous Valves
PubMed: 21740424
DOI: 10.1111/j.1469-7580.2011.01409.x -
BMC Musculoskeletal Disorders May 2022To analyze the changes of lower limb hemodynamics parameters before and after wearing graduated compression stockings (GCS) during ankle pump exercise in patients...
OBJECTIVES
To analyze the changes of lower limb hemodynamics parameters before and after wearing graduated compression stockings (GCS) during ankle pump exercise in patients preparing for arthroplastic surgery.
METHOD
The leg veins of 16 patients awaiting arthroplasty were analyzed using a Sonosite M-Turbo ultrasound system during ankle pump exercise with or without GCS. The age of them was 70 ± 7 years (mean ± SD) (range 56-82 years) and body mass index was 25.8 ± 3.0 kg/m2 (range 18.0-30.5 kg/m2). Measured data including the cross-sectional area (CSA), anteroposterior (AP) diameter and lateromedial (LM) diameter of the soleus vein (SV), posterior tibial vein (PTV) and great saphenous vein (GSV). Additionally, the peak velocities of femoral vein (FV) were also measured.
RESULTS
GCS could significantly decrease the cross-sectional area of SV, PTV and GSV in supine position at rest and maximum ankle plantar flexion. But the compression effect of GCS to SV and GSV was not observed during maximum ankle dorsiflexion. It was found that GCS application reduced the peak flow velocity of the femoral vein from 61.85 cm/s (95% CI = 50.94-72.75 cm/s) to 38.01 cm/s (95% CI = 28.42-47.59 cm/s) (P < 0.001) during ankle plantar flexion and decreased the femoral vein in these patients from 80.65 cm/s (95% CI = 70.37-90.92 cm/s) to 51.15 cm/s (95% CI = 42.58-59.73 cm/s) (P < 0.001) during ankle dorsiflexion. But this effect was not significant in supine position at rest.
CONCLUSIONS
GCS could significantly reduce the peak flow velocity of the femoral vein during ankle pump exercise in the patients preparing for arthroplastic surgery.
Topics: Aged; Aged, 80 and over; Ankle; Ankle Joint; Exercise Therapy; Femoral Vein; Humans; Middle Aged; Stockings, Compression
PubMed: 35538467
DOI: 10.1186/s12891-022-05400-y -
Journal of Vascular Surgery. Venous and... Jul 2020Chronic post-thrombotic occlusion of the iliofemoral veins causes significant morbidity, which can be alleviated if venous drainage is restored. We report our technique...
BACKGROUND
Chronic post-thrombotic occlusion of the iliofemoral veins causes significant morbidity, which can be alleviated if venous drainage is restored. We report our technique of surgical endophlebectomy and patchplasty of the common femoral vein (CFV) in conjunction with iliac vein stenting to restore venous flow from the infrainguinal venous system to the vena cava.
METHODS
There were 157 patients who underwent CFV endophlebectomy combined with iliocaval recanalization. Questionnaires were completed both preoperatively and postoperatively to allow comparison. These included the Clinical, Etiology, Anatomy, and Pathophysiology clinical classification; the Venous Clinical Severity Score; the Villalta scale; the Venous Insufficiency Epidemiological and Economic Study on Quality of Life/Symptoms; and the 36-Item Short Form Health Survey quality of life questionnaire.
RESULTS
Mean follow-up duration was 14.4 ± 2.9 months (range, 10-29 months). The mean preoperative Venous Clinical Severity Score was 15.3 ± 2.2, and this fell to 6.1 ± 1.8 after treatment (P < .001). The mean preoperative Villalta score dropped from 12.7 ± 2.6 to 6.3 ± 1.4 (P < .001). The quality of life and symptom severity scores were improved after 3 months by 17.2 points for quality of life (P < .001) and 20.5 points for symptom severity (P < .001). Primary patency was 81% (124/153) and secondary patency was 89.5% (137/153) at 12 months. Wound complications related to groin incision and lymphatic fistulas were observed in 22.8% (35/153) and 28.7% (44/153), respectively.
CONCLUSIONS
The hybrid operation of CFV endophlebectomy in conjunction with iliac vein recanalization should be considered a safe and effective treatment option in patients with severe post-thrombotic syndrome and iliofemoral veno-occlusive disease.
Topics: Adult; Aged; Angioplasty, Balloon; Chronic Disease; Combined Modality Therapy; Female; Femoral Vein; Humans; Iliac Vein; Male; Middle Aged; Postthrombotic Syndrome; Quality of Life; Retrospective Studies; Stents; Time Factors; Treatment Outcome; Vascular Patency; Vascular Surgical Procedures; Venous Thrombosis; Young Adult
PubMed: 31932247
DOI: 10.1016/j.jvsv.2019.11.008 -
The Journal of Thoracic and... Jul 2019
Topics: Femoral Vein; Mammary Arteries; Propensity Score; Radial Artery; Saphenous Vein
PubMed: 30853234
DOI: 10.1016/j.jtcvs.2019.01.032 -
World Journal of Surgery May 2022Reconstruction of the aorto-iliac segment with femoral vein (FV) as substitute for infected synthetic grafts or mycotic aneurysms constitutes the most sustainably...
BACKGROUND
Reconstruction of the aorto-iliac segment with femoral vein (FV) as substitute for infected synthetic grafts or mycotic aneurysms constitutes the most sustainably convenient alternative. The aim of this study was to evaluate the long-term outcome of up to 16 years of follow-up, analysing the morphologic adaption of the FV with special emphasis on the distal and proximal anastomoses.
METHODS
We conducted a retrospective study of 22 patients with 109 computed tomography angiograms (CTAs) treated between August 2001 and January 2020 in case of aortic infection/aortitis. Morphologic changes like anastomotic dilatation/stenosis as well as changes of FV wall thickness were retrospectively analysed in pre- and postoperative CTAs.
RESULTS
Elective procedure was done in 17/22 (77%) cases, and 5/22 (23%) patients required emergent surgery. The median follow-up was 91.5 months (P;P = 21;117). Cross-sectional diameter of proximal (20.38 ± 3.77 vs 22.04 ± 3.97 mm, p = 0.007) and distal anastomoses (13.05 ± 4.23 vs 14.61 ± 5.19 mm, p = 0.05) increased significantly, as well as the proximal and distal anastomotic areas (3.36 ± 1.29 vs 4.32 ± 1.63 mm, p = 0.04 and 0.99 ± 0.48 vs 1.25 ± 0.72 mm, p = 0.023, respectively). Venous wall thickness was significantly reduced at the anastomotic site (1.74 ± 0.46 vs 1.24 ± 0.31 mm, p = 0.001). The upper thigh diameter did not differ before and after harvesting of the FV (161.6 ± 29.1 vs. 178.2 ± 23.3 mm, p = 0.326, respectively).
CONCLUSION
This long-term CTA follow-up study showed that the FV wall becomes thinner at the anastomotic site, and the anastomoses dilate with time without rupture. The FV is a durable conductor after replacement of the aorto-iliac segment due to aortic infection. Further CTA studies from more centres are warranted to evaluate the risk of vein rupture.
Topics: Aorta; Aortic Aneurysm, Abdominal; Aortitis; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation; Femoral Vein; Follow-Up Studies; Humans; Retrospective Studies; Treatment Outcome
PubMed: 35118519
DOI: 10.1007/s00268-022-06460-w -
Annals of Vascular Surgery Jul 2022For surgical treatment of primary aortic infection and aortic graft infection, in situ reconstruction with autologous vein(s) has the lowest rates of re-infection and of...
BACKGROUND
For surgical treatment of primary aortic infection and aortic graft infection, in situ reconstruction with autologous vein(s) has the lowest rates of re-infection and of graft thrombosis. In this study, we have assessed the outcome after autologous femoral vein reconstruction in patients with aortic (graft) infection and we provide insights into the specific technical surgical considerations of the procedure.
METHODS
In this retrospective single-center study, all patients who underwent autologous femoral vein reconstruction because of primary aortic infection or aortic graft infection between January 2012 and January 2020 were included. The primary outcome parameter was 30-day mortality.
RESULTS
Twenty-nine patients with autologous femoral vein reconstruction for a primary aortic infection (n = 3) or aortic graft infection (n = 26) were included. An aorto-enteral fistula was detected in 13 patients (49%). Venous reconstruction of the aorta was performed with a single femoral vein in 17 patients (59%), and two femoral veins in 12 patients (41%). Thirty-day mortality was 17%. Relapse of infection occurred in two patients (7%) and no amputations were needed. One year after surgery, only three patients (10%) still needed stockings and after 2 years none of the patients used stockings.
CONCLUSIONS
Central aortic reconstruction with femoral veins is a durable solution for primary aortic and aortoiliac graft infections with a low incidence of reinfections, amputations, and venous hypertension.
Topics: Aorta; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation; Femoral Vein; Humans; Prosthesis-Related Infections; Reoperation; Retrospective Studies; Treatment Outcome
PubMed: 34933108
DOI: 10.1016/j.avsg.2021.11.012