Early results of external iliac artery stenting combined with common femoral artery endarterectomy

22-year-old man with a history of multiple episodes of bleeding, bruising, and hematomas Coronal VR image from 3D CE MRA of the abdomen and pelvis (Figure 16.11.1) reveals lobulated aneurysms of both external iliac arteries and the right common femoral artery. Note the severe stenosis of the left external iliac artery distal to the aneurysm....

Download Full-text

QS252. Iatrogenic Injuries of the Common Femoral Artery (CFA) and External Iliac Artery (EIA) During Endograft Placement: An Underdiagnosed Entity

Journal of Surgical Research ◽

10.1016/j.jss.2008.11.555 ◽

2009 ◽

Vol 151 (2) ◽

pp. 293

Author(s):

A. Hingorani ◽

E. Ascher ◽

N. Marks ◽

A. Shiferson ◽

N. Patel ◽

...

Keyword(s):

Femoral Artery ◽

Iliac Artery ◽

External Iliac Artery ◽

Common Femoral Artery ◽

Iatrogenic Injuries ◽

The Common

Download Full-text

Deep Circumflex Iliac Artery as an Inflow Alternative for Surgical Revascularization: A Case Report

Vascular and Endovascular Surgery ◽

10.1177/1538574419877730 ◽

2019 ◽

Vol 54 (1) ◽

pp. 85-88

Author(s):

Makoto Haga ◽

Shinya Motohashi ◽

Hidenori Inoue ◽

Junetsu Akasaka ◽

Shunya Shindo

Keyword(s):

Femoral Artery ◽

Iliac Artery ◽

Bypass Graft ◽

External Iliac Artery ◽

Common Femoral Artery ◽

Surgical Revascularization ◽

Deep Circumflex Iliac Artery ◽

The Common ◽

Artery Disease ◽

Pain At Rest

The common femoral artery (CFA) is the most widely used inflow in all types of surgical revascularization in patients with peripheral artery disease. However, the CFA cannot always be used because of calcification, obstruction, or previous dissection. Here, we report a rare case of selecting the deep circumflex iliac artery (DCIA) as a source of inflow to perform a surgical revascularization in a patient with chronic limb-threatening ischemia. A 62-year-old man was admitted to our hospital due to necrotized third and fifth toes with pain at rest. Computed tomography showed severe stenosis of the CFA, superficial femoral artery, and deep femoral artery, and an entirely stented external iliac artery. The DCIA was identified as the only patent artery. Considering the condition of the other arteries, we selected the DCIA as a source of inflow. Deep circumflex iliac–popliteal bypass was performed with a saphenous vein. The bypass graft was patent 9 months after surgery and limb salvage had been achieved.

Download Full-text

Early Detection of Post-Endarterectomy Complication by Point-of-Care Ultrasound

Reports ◽

10.3390/reports4030021 ◽

2021 ◽

Vol 4 (3) ◽

pp. 21

Author(s):

Bo-Ku Chen ◽

Po-Wei Chiu ◽

Chih-Hao Lin

Keyword(s):

Femoral Artery ◽

Point Of Care ◽

Postoperative Bleeding ◽

External Iliac Artery ◽

Common Femoral Artery ◽

Atheromatous Plaque ◽

Point Of Care Ultrasound ◽

Related Complication ◽

Contrast Extravasation ◽

The Right

Endarterectomy is an effective intervention to remove the atheromatous plaque in the inner lining of the artery, aiming to revascularize the occluded/stenosed vessel in patients with peripheral arterial occlusive disease (PAOD). The most common wound-related complication is postoperative bleeding, followed by infection, hematoma, and seroma. However, hematoma complications with air surrounded have rarely been reported in clinical cases. Case presentation: A 90-year-old female patient visited our emergency department because of a rapidly growing hematoma with pulsatile bleeding over her right groin area. She had received bilateral percutaneous transluminal angioplasty with endarterectomy for PAOD one month prior. A point-of-care ultrasound revealed a large hypoechoic mass, with a dirty shadow on the right groin area. Computed tomography angiography showed a hematoma over her right femoral region, with free air surrounding the right femoral artery. Angiography revealed an irregular shaped lesion on the right femoral artery without contrast extravasation. The patient was diagnosed with right-femoral post-endarterectomy infection with infected hematoma, with the inclusion of air. She underwent urgent excision and repair of the right femoral artery infectious lesion, debridement of the infectious hematoma and stenting of the right external iliac artery, common femoral artery and superficial femoral artery.

Download Full-text

Healing of femoral artery dissection after drug-coated balloon angioplasty: A case report with intravascular ultrasonography and angioscopy images

SAGE Open Medical Case Reports ◽

10.1177/2050313x19834159 ◽

2019 ◽

Vol 7 ◽

pp. 2050313X1983415

Author(s):

Taketsugu Tsuchiya ◽

Minako Oda ◽

Takaaki Takamura ◽

Katsuhide Kitagawa ◽

Koji Kajinami ◽

...

Keyword(s):

Femoral Artery ◽

Balloon Angioplasty ◽

Iliac Artery ◽

Superficial Femoral Artery ◽

External Iliac Artery ◽

Artery Dissection ◽

Intravascular Ultrasonography ◽

Stent Deployment ◽

Atherosclerotic Stenosis ◽

Drug Coated Balloon

Early 80s male with intermitted claudication underwent endovascular therapy for atherosclerotic stenosis at left external iliac artery and middle of superficial femoral artery. Patient also had chronic atrial fibrillation, diabetes mellitus, and hypertension. After stent deployment for external iliac artery lesion, a short superficial femoral artery lesion was performed with angioplasty using drug-coated balloon. The drug-coated balloon angioplasty resulted in 50% residual stenosis with linear dissection; however, provisional stenting was not performed as decent ante-grade blood flow allowed 10 extra minutes. Medication involved ongoing use of aspirin 100 mg and rivaroxaban 15 mg. Angiography post 3 months from index procedure showed external iliac artery and superficial femoral artery patency and healing of intimal dissection at superficial femoral artery lesion was estimated by intravascular ultrasonography. In angioscopy findings, red thrombus was seen in dissection cavity.

Download Full-text

Noninvasive Detection of Iliac Artery Disease and Prediction of Its Severity from Doppler Spectral Analysis in Common Femoral Artery

Angiology ◽

10.1177/000331979704800708 ◽

1997 ◽

Vol 48 (7) ◽

pp. 615-621 ◽

Cited By ~ 2

Author(s):

Shinji Makita ◽

Atsushi Ohira ◽

Hirofumi Murakami ◽

Shigehiro Itoh ◽

Katsuhiko Hiramori ◽

...

Keyword(s):

Spectral Analysis ◽

Femoral Artery ◽

Iliac Artery ◽

Common Femoral Artery ◽

Noninvasive Detection ◽

Artery Disease ◽

Doppler Spectral Analysis

Download Full-text

Control of Hemorrhage in Critical Femoral or Inguinal Penetrating Wounds—An Ultrasound Evaluation

Prehospital and Disaster Medicine ◽

10.1017/s1049023x00004076 ◽

2006 ◽

Vol 21 (6) ◽

pp. 379-382 ◽

Cited By ~ 18

Author(s):

Michael Blaivas ◽

Stephen Shiver ◽

Matthew Lyon ◽

Srikar Adhikari

Keyword(s):

Flow Velocity ◽

Abdominal Aorta ◽

Femoral Artery ◽

Iliac Artery ◽

Common Femoral Artery ◽

Body Armor ◽

Mean Flow ◽

Mean Velocity ◽

Flow Measurements ◽

Ultrasound Evaluation

AbstractIntroduction:Exsanguination from a femoral artery wound can occur in sec-onds and may be encountered more often due to increased use of body armor. Some military physicians teach compression of the distal abdominal aorta (Abdominal Aorta) with a knee or a fist as a temporizing measure.Objective:The objective of this study was to evaluate if complete collapse of the Abdominal Aorta was feasible and with what weight it occurs.Methods:This was a prospective, interventional study at a Level-I, academ-ic, urban, emergency department with an annual census of 80,000 patients. Written, informed consent was obtained from nine male volunteers after Institutional Research Board approval. Any patient who presented with abdominal pain or had undergone previous abdominal surgery was excluded from the study. Subjects were placed supine on the floor to simulate an injured soldier. Various dumbbells of increasing weight were placed over the distal Abdominal Aorta, and pulsed-wave Doppler measurements were taken at the right common femoral artery (CFA). Dumbbells were placed on top of a tightly bundled towel roughly the surface area of an adult knee. Flow measurements at the CFA were taken at increments of 20 pounds. This was repeated with weight over the proximal right artery iliac and distal right iliac artery to eval- uate alternate sites. Descriptive statistics were utilized to evaluate the data.Results:The mean velocity through the CFA was 75.8 cm/ sec at 0 pounds. Compression of the Abdominal Aorta ranging 80 to 140 pounds resulted in no flow in the CFA. A steady decrease in mean flow velocity was seen starting with 20 pounds. Flow velocity decreased more rapidly with compression of the prox- imal right iliac artery, and stopped in all nine volunteers by 120 pounds of pressure. For all nine volunteers, up to 80 pounds of pressure over the distal iliac artery failed to decrease CFA flow velocity, and no subject was able to tolerate more weight at that location.Conclusion:Flow to the CFA can be stopped completely with pressure over the distal Abdominal Aorta or proximal iliac artery in catastrophic wounds. Compression over the proximal iliac artery worked best, but a first responder still may need to apply upward of 120 pounds of pressure to stop exsanguination.

Download Full-text