Inter-fascial space between SArtorius muscle and FEmoral artery (ISAFE): A suggested approach for Adductor Canal catheter placement

Abstract Introduction: Saphenous nerve is the longest and largest pure sensory nerve, supplying the medial side of the thigh, leg and foot. Materials and Methods: In the present case study, during routine cadaveric dissection of the antero-medial part of the thigh, an interesting anomalous pattern of saphenous nerve was seen in the right lower limb of a 62 years old embalmed male cadaver from the Department of Human Anatomy, Universiti Putra Malaysia (UPM). Results: This saphenous nerve can be recognised as an unusual anatomical variant in which it gives a motor branch to the sartorius muscle during traversing the adductor canal and it was accompanied by blood vessels at the same time. The nerve continues its usual course and pierces the fascia lata, between the tendon of sartorius and gracilis and becomes subcutaneous. Conclusion: Knowledge of the variant anatomy of the saphenous nerve is important to surgeon in avoiding nerve injuries during adductor canal nerve block, nerve entrapment surgery, reconstructive surgery, pain management services and knee surgery successfully.

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Assessment of femoral artery atherosclerosis at the adductor canal using 3D black-blood MRI

Clinical Radiology ◽

10.1016/j.crad.2012.12.002 ◽

2013 ◽

Vol 68 (4) ◽

pp. e213-e221 ◽

Cited By ~ 3

Author(s):

J. Chi ◽

B. Chiu ◽

Y. Cao ◽

X. Liu ◽

J. Wang ◽

...

Keyword(s):

Femoral Artery ◽

Black Blood ◽

Adductor Canal ◽

Black Blood Mri

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Femoral Artery Dissection after Adductor Canal Block

Anesthesiology ◽

10.1097/aln.0000000000002627 ◽

2019 ◽

Vol 130 (6) ◽

pp. 1037-1038 ◽

Cited By ~ 1

Author(s):

Leon Vorobeichik ◽

Faraj W. Abdallah

Keyword(s):

Femoral Artery ◽

Artery Dissection ◽

Adductor Canal Block ◽

Adductor Canal

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Bacterial Infection from Intravascular Monitoring Devices

Infection Control ◽

10.1017/s019594170005983x ◽

1983 ◽

Vol 4 (5) ◽

pp. 399-404 ◽

Cited By ~ 6

Author(s):

Charles W. Stratton ◽

H. Bradford Hawley

Keyword(s):

Critical Care ◽

Bacterial Infection ◽

Radial Artery ◽

Femoral Artery ◽

Systemic Infection ◽

Catheter Placement ◽

Local Infection ◽

The Past ◽

Monitoring Devices

During the past decade intravascular monitoring has become commonplace in hospital critical care areas. Early reports, such as that of Gardner et al, reassured us that these devices were safe. In fact, Gardner and associates noted not a single local or systemic infection that could be definitely related to radial artery monitoring catheters in 531 patients. Results of a more recent study by Band and Maki are more sobering. They found a 4% incidence of septicemia and an 18% incidence of local infection when they prospectively studied 130 arterial catheters in 95 patients. There were many differences between these two studies, but perhaps the two most important factors leading to the higher incidence of infection in the later study were increased duration of catheter placement and placement of the catheter by surgical cutdown or in a femoral artery.

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Femoral Artery Pseudoaneurysm Caused by an Osteochondroma of the Femur: A Case Report

Journal for Vascular Ultrasound ◽

10.1177/154431670302700111 ◽

2003 ◽

Vol 27 (1) ◽

pp. 51-54 ◽

Cited By ~ 2

Author(s):

Courtney Nelms ◽

Kathleen Carter ◽

Richard DeMasi ◽

George Meier ◽

Dulcie Chaler ◽

...

Keyword(s):

Case Report ◽

Femoral Artery ◽

Young Patients ◽

Vascular Complications ◽

Left Thigh ◽

Artery Pseudoaneurysm ◽

Adductor Canal ◽

Common Benign Tumor ◽

Arterial Complications ◽

Pulsatile Mass

Introduction The osteochondroma is the most common benign tumor of bone. Typically asymptomatic bony protuberances are discovered in childhood or adolescence. Although vascular complications are rare, these bony spikes can course along an artery and cause severe arterial complications. Reported here is a case involving the use of color duplex ultrasonography (CDU) to identify a superficial femoral artery (SFA) pseudoaneurysm as a result of an osteochondroma. Case Report A 12-year-old girl had been experiencing left lower extremity pain for approximately 2 months. The pain became progressively severe, and her parents noticed that she was limping. Magnetic resonance imaging (MRI) demonstrated a mass in the left thigh, suggesting the possibility of a femoral aneurysm. A bony spicule was noted on x-ray at the distal femur, projecting posteriorly. Clinical evaluation revealed an impressive pulsatile mass in the left distal medial thigh. The left thigh was noticeably larger than the right with poor pedal pulses compared with the asymptomatic limb. CDU was performed and identified an aneurysm of the SFA at the adductor canal. There was unusual oscillatory flow in the SFA proximal to the aneurysm with monophasic signals distally. The large aneurysm size displaced the normal anatomic course of the SFA and vein. Ankle-brachial indices (ABI) were 0.72 and monophasic in the affected limb and >1.0 and triphasic in the contralateral limb. Angiography confirmed the CDU and MRA findings, demonstrating a large pseudoaneurysm at the adductor canal caused by an osteochondroma of the femur. At time of surgical repair, the bony spicule was noted to have eroded into the femoral artery. Conclusion Vascular complications as a result of an osteochondroma are rare. Rapid diagnosis is necessary to prevent serious arterial compromise in these young patients. CDU can quickly and accurately confirm the presence of a pseudoaneurysm when an osteochondroma is suspected.

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