On-Site–Modified Sheath to Overcome the Undesirable Catheterization of the Profunda Femoris Artery During Antegrade Femoral Access

2020 ◽  
Vol 27 (3) ◽  
pp. 505-508 ◽  
Author(s):  
August Ysa ◽  
Marta Lobato ◽  
Amaia Arruabarrena ◽  
Ana M. Quintana ◽  
Roberto Gómez ◽  
...  
Keyword(s):  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Common Femoral Artery ◽  
Simple Method ◽  
Femoral Access ◽  
Profunda Femoris Artery ◽  
Distal Marker ◽  
Antegrade Puncture ◽  
Repeated Passage ◽  
Profunda Femoris

Purpose: To present a simple method to avoid favored passage of a guidewire into the profunda femoris artery (PFA) after antegrade puncture of the common femoral artery. Technique: A 6-F conventional introducer sheath with a radiopaque distal marker is placed on the nurse’s table with its side port orientated to the 12 o’clock position. A small (2–2.5 mm) oval fenestration is created on the superior aspect of the sheath about 3 cm from its tip with a size 11 surgical blade. The modified introducer is passed over the angled 0.035-inch guidewire into the PFA and gently retrieved until the tip marker is ~3 cm from the femoral bifurcation. The dilator is removed, and the guidewire is withdrawn to the level of the fenestration, manipulated through it, and advanced further into the superficial femoral artery under fluoroscopic guidance. Conclusion: When repeated passage of the guidewire down the PFA persists despite conventional manipulation of the wire or needle, an on-site modification of the sheath is an easy alternative approach for the catheterization of the superficial femoral artery.

A Synchronous Ipsilateral True Superficial Femoral Artery and Profunda Femoris Artery Aneurysm With Rupture: A Case Report and Review of the Literature

2020 ◽  
Vol 54 (7) ◽  
pp. 650-655
Author(s):  
Ali Ahmet Arıkan ◽  
Fatih Avni Bayraktar ◽  
Emre Selçuk
Keyword(s):  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Treatment Options ◽  
Artery Aneurysm ◽  
Rare Condition ◽  
Review Of The Literature ◽  
Profunda Femoris Artery ◽  
Elderly Males ◽  
History Of ◽  
Profunda Femoris

Atherosclerotic true aneurysms of the superficial femoral artery (SFA) and profunda femoris artery (PFA) are rare and difficult to detect. The synchronous presence of SFA and PFA aneurysms is even rarer. Herein, we present a case with ipsilateral true SFA and PFA aneurysms diagnosed with rupture. A review of the international literature is made, and the diagnosis and treatment options of this rare condition are discussed. A 75-year-old male was admitted to our hospital with an aneurysm on the distal SFA and the ipsilateral PFA, as well as a hematoma around the PFA. It was difficult to determine the source of the rupture before surgery, even with proper imaging. Successful ligation of the PFA and an aneurysmectomy followed by a bypass grafting for the SFA were performed. An intraoperative examination revealed that the SFA aneurysm had ruptured. In elderly males with a history of ectasia or aneurysm on the aorta or peripheral arteries, a synchronous aneurysm on the SFA or the PFA should be suspected.

scholarly journals Absence of the genicular arterial anastomosis as generally depicted in textbooks

2013 ◽  
Vol 95 (6) ◽  
pp. 405-409 ◽  
Author(s):  
M Sabalbal ◽  
M Johnson ◽  
V McAlister
Keyword(s):  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Popliteal Artery ◽  
Collateral Circulation ◽  
Lower Limbs ◽  
Direct Communication ◽  
Profunda Femoris Artery ◽  
Arterial Anastomosis ◽  
Lateral Circumflex Femoral ◽  
Profunda Femoris

Introduction Textbook representations of the genicular arterial anastomosis show a large direct communication between the descending branch of the lateral circumflex femoral artery (DBLCFA) and a genicular branch of the popliteal artery but this is not compatible with clinical experience. The aim of this study was to determine whether the arterial anastomosis at the knee is sufficient, in the event of traumatic disruption of the superficial femoral artery, to infuse protective agents or to place a stent to restore flow to the lower leg. Methods Dissection of ten cadaveric lower limbs was performed to photograph the arterial anatomy from the inguinal ligament to the tibial tubercle. Anastomosis with branches of the popliteal artery was classified as: ‘direct communication’, ‘approaching communication’ or ‘no evident communication’. Results A constant descending artery in the lateral thigh (LDAT) was found to have five types of origin: Type 1 (2/10 limbs) involved the lateral circumflex femoral branch of the femoral artery, Type 2 (3/10 limbs) the lateral circumflex femoral branch of the profunda femoris artery, Type 3 (1/10 limbs) the femoral artery, Type 4 (3/10 limbs) the superficial femoral artery and Type 5 (2/10 limbs) the profunda femoris artery. In one limb, there were two descending arteries (Types 4 and 5). Collateral circulation at the knee was also variable: direct communicating vessels (3/10 limbs); approaching vessels with possible communication via capillaries (5/10 limbs); no evident communication (2/10 limbs). Communicating vessels, if present, are too small to provide immediate collateral circulation. Conclusions Modern representations of the genicular arterial anastomosis are inaccurate, derived commonly from an idealised image that first appeared Gray’s Anatomy in 1910. The afferent vessel is not the DBLCFA. The majority of subjects have the potential to recruit collateral circulation via the LDAT following gradual obstruction to normal arterial flow, which may be important if the LDAT is removed for bypass or flap surgery. A direct communication is rarely present and is never as robust as generally depicted in textbooks.

scholarly journals Aberrant configuration of femoral vessels as cause of arterial occlusive disease

2018 ◽  
Vol 5 (5) ◽  
pp. 1962
Author(s):  
Ankit Ahuja ◽  
Vinay Naithani ◽  
Amit Kumar Bagara ◽  
Budhi Prakash Bhatia
Keyword(s):  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Relevant Literature ◽  
Arterial Occlusive Disease ◽  
Occlusive Disease ◽  
Lower Limbs ◽  
Clinical Implications ◽  
Profunda Femoris Artery ◽  
Femoral Vessels ◽  
Profunda Femoris

Variations in the branching pattern of femoral and profunda femoris arteries have clinical implications while performing various diagnostic imaging procedures as well as during surgeries that are performed in the femoral triangle. Awareness about these variations aid surgeons during preoperative clinical evaluation for surgical and interventional revascularization of the ileo-femoral and femoro-popliteal segments, in open canulation of femoral artery for cardiopulmonary bypass, in radiological interventions for A-V malformations, and in salvage operations for traumatic limb ischemia. Here we report an aberrant configuration of profunda femoris artery which presented as a case of arterial occlusive disease of lower limb. On surgical exploration, Profunda femoris artery was found originating on the medial aspect of left common femoral artery high up in the inguinal region as compared to its usual lower and lateral origin. There was atheromatous occlusion of superficial femoral artery from its origin upto distal femoral metaphysis. In case of occlusion of the superficial femoral artery, the profunda femoris artery forms an effective collateral bed between the ileo-femoral segment and the popliteal artery and its branches. The clinical implications associated with these variations in therapeutic and diagnostic interventions is been discussed along with relevant literature review. Further study is necessary to identify aberrant configuration of femoral vessels as a cause of arterial occlusive disease in the lower limbs.

A Variant Origin Of Profunda Femoris Artery and A Common Stem for the origin of Medial And Lateral Circumflex Arteries – A Case Report

2017 ◽  
Vol 1 (4) ◽  
Author(s):  
Pralhad D. S.
Keyword(s):  
Case Report ◽  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Popliteal Artery ◽  
Lower Limb ◽  
Considerable Extent ◽  
Profunda Femoris Artery ◽  
Left Lower Limb ◽  
Profunda Femoris

The variations of the profunda and its branches are numerous and to a considerable extent, largely associated with one another. In occlusion of the superficial femoral artery, the profunda femoris artery forms an effective collateral bed between the ileo-femoral segment and the popliteal artery and its branches. Acharya Sushrutha has clearly mentioned about the importance of dissection., One who is intended to acquire definite knowledge of surgery should keenly study the anatomy from the books as well as from the dissection. Femoral artery is the most important artery supplying the lower limb and in case of cadavers this artery is used for the embalmment procedure. During the routine dissection classes for the UG’s, a variation was observed in the origin of profunda femoris and a common stem for the origin of medial and lateral circumflex arteries in the left lower limb.

Ultrasound-guided antegrade femoral access: comparison between the common femoral artery and the superficial femoral artery

2010 ◽  
Vol 21 (6) ◽  
pp. 1323-1328 ◽  
Author(s):  
A. Gutzeit ◽  
N. Graf ◽  
E. Schoch ◽  
T. Sautter ◽  
R. Jenelten ◽  
...  
Keyword(s):  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Common Femoral Artery ◽  
Ultrasound Guided ◽  
Femoral Access ◽  
The Common

High origin of Profunda Femoris Artery - A Case Report

2017 ◽  
Vol 2 (05) ◽  
Author(s):  
Ashwinikumar Waghmare ◽  
Malashri .
Keyword(s):  
Femoral Artery ◽  
Lower Limb ◽  
Rectus Femoris ◽  
Inguinal Ligament ◽  
Vastus Medialis ◽  
Medial Aspect ◽  
Lateral Aspect ◽  
Profunda Femoris Artery ◽  
Male Cadaver ◽  
Profunda Femoris

Profunda Femoris Artery (PFA) arises from lateral aspect of femoral artery 3.5 cm distal to inguinal ligament. It gives lateral and medial circumflex femoral arteries from lateral and medial aspect respectively. Following variation was reported in right lower limb of a 60 year male cadaver, during routine dissection for medical students. Profunda Femoris Artery (PFA) arose from lateral aspect of femoral artery 1 cm distal to inguinal ligament, running laterally and down words parallel to femoral artery the profunda femoris passed beneath rectus femoris, sartorius and vastus medialis successively, finally pierced adductor magnus as forth perforator artery, 6 cm above knee joint.

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