The Mid-Distal Deep Femoral Artery: Few Important Centimeters in Vascular Surgery

The infection in vascular surgery is a nightmare of every vascular surgeon. There are numerous ways of treatment but neither one is definitive. We present the case of the patient with infectious limb following aortobifemoral reconstruction treated by partial graft extirpation and with re-implantation of the superficial femoral artery into deep femoral artery.

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Surgery of the Deep Femoral Artery

10.1007/978-3-642-79045-4 ◽

1994 ◽

Author(s):

Marco P. Merlini ◽

R. J. A. M. van Dongen ◽

Michael Dusmet

Keyword(s):

Femoral Artery ◽

Deep Femoral Artery

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Does Deep Femoral Artery Revascularization as an Isolated Procedure Play a Role in Chronic Critical Limb Ischemia?

Journal of Endovascular Therapy ◽

10.1583/03-1060.1 ◽

2004 ◽

Vol 11 (2) ◽

pp. 119-124 ◽

Cited By ~ 31

Author(s):

Nicolas Diehm ◽

Hannu Savolainen ◽

Felix Mahler ◽

Jürg Schmidli ◽

Do-Dai Do ◽

...

Keyword(s):

Femoral Artery ◽

Critical Limb Ischemia ◽

Limb Ischemia ◽

Deep Femoral Artery ◽

Chronic Critical Limb Ischemia

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Endovascular therapy for severely calcified plaque at the superficial femoral artery using myocardial biopsy forceps

CVIR Endovascular ◽

10.1186/s42155-021-00257-z ◽

2021 ◽

Vol 4 (1) ◽

Author(s):

Shojiro Hirano ◽

Atsushi Funatsu ◽

Shigeru Nakamura ◽

Takanori Ikeda

Keyword(s):

Femoral Artery ◽

Superficial Femoral Artery ◽

Calcium Score ◽

Biopsy Forceps ◽

Myocardial Biopsy ◽

Deep Femoral Artery ◽

Total Occlusion ◽

Stent Expansion ◽

Calcified Plaque ◽

The Right

Abstract Background Currently, the success rate of EVT for treating CTO of the SFA is high; however, EVT is still found to be insufficient in treating CTOs with severely calcified lesions. Even if the guidewire crosses the lesion, the calcifications may still cause difficulties during stent expansion. Main text A 78-year-old male had been reported to have intermittent claudication with chronic total occlusion (CTO) of the right superficial femoral artery (SFA). Angiography revealed severely calcified plaque (Angiographic calcium score: Group4a [1]) at the ostium of the SFA. Stenting posed a risk of underexpansion, causing the plaque to shift to the deep femoral artery. we decided to remove the calcified plaque using biopsy forceps. After removing the extended calcified plaque, the guidewire could cross easily, and the self-expandable stent was well dilated without causing the plaque to shift to the DFA. Conclusions Biopsy forceps may be used in some endovascular cases to remove severely calcified lesions. To ensure the safety of the patient, the physician must be adept at performing this technique before attempting it.

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Deep Femoral Artery Branch

10.32388/mirq67 ◽

2020 ◽

Author(s):

Keyword(s):

Femoral Artery ◽

Deep Femoral Artery ◽

Artery Branch

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Retrograde Cement Extrusion into Femoral Nutrient Vessels Following Uncomplicated Total Hip Arthroplasty

IIUM Medical Journal Malaysia ◽

10.31436/imjm.v16i1.1176 ◽

2017 ◽

Vol 16 (1) ◽

Author(s):

Lim Chia Hua ◽

V.A. Jacob ◽

N. Premchandran

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Femoral Artery ◽

Femoral Stem ◽

Deep Femoral Artery ◽

Neck Of Femur ◽

Term Survival ◽

Stem Size ◽

Total Hip ◽

Femoral Cortex

The present concepts in Total Hip Arthroplasty advocate mechanical cement interlock with trabecular bone utilising the third-generation cementing technique. However, the force generated can easily reach peak pressure of 122 kPa to 1500 kPa, leading to extrusion of cement through nutrient foramina into femoral cortex into nutrient vessels, henceforth the retrograde arteriovenogram. A 76 years old lady who premorbid ADLindependent had a fall and sustained a closed right neck of femur fracture. She underwent cemented right total hip arthroplasty. Acetabulum cup of 47mm and femoral stem size 1 was utilized. Femoral canal was prepared and medullary cavity plug inserted before retrograde cement was introduced using the cementing gun. Intraoperative no complications were noted. This case has been followed up to a year with no adverse effect. The post-operative radiograph demonstrated a linear radio-opacity communicating with the posterior aspect of the femoral shaft which continues proximally and medially for approximately 10cm. Its uniformity in shape and position corresponds to the vascular supply of proximal femur. In Farouk et al cadaveric study, nutrient vessel arises in 166 ± 10 mm from the greater trochanter and is a branch of the second perforating artery from the deep femoral artery. Knight et al infer that retrograde cement extrusion occurs in female patients with small stature and small endosteal canal. Cement extrusion unlikely will influence the long haul survival of prosthesis as shown in the radiograph that cement is well pressurized to interlock with the endosteal bone. Moreover, because of extensive anastomoses of perforating branches of the deep femoral artery, segmental obliteration of nutrient artery alone is unlikely to lead to vascularity issues. Cement extrusion into the nutrient foramen is a vital differential in presence of posterior medial cement in the diaphysis of the femur following total hip replacement. This is to differentiate from extra osseous extrusions due to the iatrogenic breach of the femoral cortex suggesting periprosthetic fracture which affects the long term survival of prosthesis.

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