scholarly journals Successful limb salvage beyond the golden time following blunt traumatic open complete transection of the femoral artery and vein in a patient with cardiac arrest: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Hoshi Himura ◽  
Kenichiro Uchida ◽  
Masahiro Hiyashita ◽  
Yasumitsu Mizobata
Keyword(s):  
Cardiac Arrest ◽  
Femoral Artery ◽  
Lower Limb ◽  
Damage Control ◽  
Damage Control Resuscitation ◽  
Deep Femoral Artery ◽  
Injured Limb ◽  
Circumflex Artery ◽  
Complete Transection ◽  
Lateral Femoral Circumflex Artery

Abstract Background Open complete transection of the femoral artery and vein following blunt trauma is extremely rare. Furthermore, even if the patient has been successfully resuscitated, it is sometimes difficult in most patients to preserve the injured limb, especially after damage control resuscitation. We report a case of open complete transection of the femoral artery and vein secondary to high-energy blunt trauma and a successful limb preservation treatment strategy. Case presentation A 57-year-old Asian man was transferred to hospital after having fallen from the 15th floor of a condominium. The patient was in cardiac arrest at the scene, but was successfully resuscitated by emergency medical services staff. On arrival, the patient’s hemodynamics were completely collapsed with active external bleeding from the thigh, so we immediately started resuscitation including activation of massive transfusion protocol and temporarily ligated the transected proximal superficial femoral artery, deep femoral artery just distal after branching lateral femoral circumflex artery and the superficial femoral vein. Following radiological findings showing a potential pelvic fracture with active bleeding, we also performed retroperitoneal packing in the resuscitation room and moved the patient to the angiography room for transcatheter arterial embolization. The patient’s consciousness was preserved and perfusion of the injured limb was barely maintained after his hemodynamics were adequately stabilized. As we detected weak perfusion of the lower limb via a potential collateral flow from the lateral femoral circumflex artery branches from deep femoral artery by pulse doppler of the dorsal pedis artery, we decided to reconstruct superficial femoral artery and vein at 24 h after injury using great saphenous vein bypass grafts. The patient was transferred to a rehabilitation hospital with good neurological and limb outcome after hospitalization for 52 days. Conclusion We successfully preserved the patient’s lower limb after cardiac arrest and complete transection of the femoral artery and vein and achieved a good neurological outcome. Even if a femoral artery needs to be ligated temporarily, careful observation and assessment should be performed so as not to lose the chance to salvage the limb even during damage control resuscitation.

TO INVESTIGATE BRANCHED ANATOMICAL FEATURES OF THE LATERAL FEMORAL CIRCUMFLEX ARTERY USED IN THE CONSTRUCTION OF THE COMPOSITE ANTEROLATERAL THIGH (ALT) FLAP

2020 ◽  
pp. 89-98
Author(s):  
Phuc Le Hong ◽  
Son Tran Thiet ◽  
Khoa Tran Dang
Keyword(s):  
Femoral Artery ◽  
Descriptive Analysis ◽  
Circumflex Artery ◽  
Cross Sectional ◽  
Anatomical Features ◽  
Anterolateral Thigh ◽  
Lateral Femoral Circumflex Artery ◽  
Research Standards ◽  
Anatomical Research ◽  
Alt Flap

Introduction: The research of the lateral femoral circumflex artery has been studied and applied in many clinical fields. Objectives: To investigate branched anatomical features of the lateral femoral circumflex artery used in the construction of the composite anterolateral thigh (ALT) flap. Patients and research methods: 60 thigh areas of 30 Vietnamese adult cadavers meeting the research standards were conducted cross-sectional descriptive analysis. Result: lateral femoral circumflex artery usually has three branches that are ascending branch, oblique branch and descending branch. Descending branch usually separated independently (11.7%), oblique branch and ascending branch often have common body (83.3%). The majority of ascending branches have origin from lateral femoral circumflex (76.7%). Ascending branche has average of 4.1 branches to supply the anterior thigh muscles. Ascending branches has 2-3 cutaneous perforators were the majority (41.7%). There are 73 descending branch, 75.34% descending branch from the original branch of the lateral femoral circumflex artery, 8.22% lateral femoral circumflex artery from femoral artery and 16.44% descending branch from deep femoral artery. Averaging descending branch has 8.9 ± 0.2 branches to muscles of anteriolateral thigh area and on average had 3.1 ± 0.3 perforators per thigh specimen. The number of branches to lateralis muscles was at most 7.9 ± 0.4 branhes. Conclusion: Anatomical research of the lateral femoral circumflex artery branching as a premise to build a composite ALT flaps with lateralis component or with TFL makes sense in the creation of workhorse materials in clinical application. Key words: lateral femoral circumflex artery

The deep femoral artery, a readily available inflow vessel for lower limb revascularization: a single-center experience

Vascular ◽  
2013 ◽  
Vol 21 (2) ◽  
pp. 75-78 ◽  
Author(s):  
Daniel Silverberg ◽  
Basheer Sheick-Yousif ◽  
Dmitry Yakubovitch ◽  
Moshe Halak ◽  
Jacob Schneiderman
Keyword(s):  
Lower Extremity ◽  
Femoral Artery ◽  
Lower Limb ◽  
Bypass Graft ◽  
Graft Patency ◽  
Primary Patency ◽  
Single Center ◽  
Deep Femoral Artery ◽  
Single Center Experience

The deep femoral artery (DFA) offers several advantages as an inflow vessel in lower-extremity bypasses. We report a single-center experience using the DFA as an inflow artery for lower-extremity revascularization. We reviewed all patients who underwent a lower-extremity bypass utilizing the DFA as the inflow vessel. Demographics, indications for surgery, indication for use of the DFA, type of conduits and target vessels were recorded. Follow-up data included resolution of symptoms, bypass graft patency, major amputations and survival. Over 2.5 years, 23 patients were treated with a DFA-inflow bypass. Eighteen (78%) suffered from wounds and five (22%) from rest pain. The proximal, middle and distal DFA was used in 8, 14 and 1 patients, respectively. Indications for using the DFA were limited vein conduit (16) and a hostile groin (5). All patients experienced initial resolution of their ischemic symptoms. The primary patency at two years was 93%. The survival rate was 83%. In conclusion, the DFA is an excellent and underutilized alternative inflow artery in patients requiring lower limb revascularization. It offers excellent patency rates and should be considered in patients with hostile groins or insufficient lengths of a vein conduit.

scholarly journals Cardiac arrest due to massive hemorrhage from uterine adenomyosis with leiomyoma successfully treated with damage control resuscitation

2016 ◽  
Vol 3 (4) ◽  
pp. 388-391
Author(s):  
Takeshi Yagi ◽  
Motoki Fujita ◽  
Tomoaki Inoue ◽  
Mari Otsuji ◽  
Yasutaka Koga ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Damage Control ◽  
Massive Hemorrhage ◽  
Damage Control Resuscitation ◽  
Uterine Adenomyosis

scholarly journals Deep Femoral Artery Aneurysm Presenting as Lower Limb Swelling: A Case Report

2006 ◽  
Vol 47 (1) ◽  
pp. 148 ◽  
Author(s):  
Yong-Pil Cho ◽  
Soo-Jung Choi ◽  
Tae-Won Kwon ◽  
Myoung-Sik Han ◽  
Yong-Ho Kim ◽  
...  
Keyword(s):  
Case Report ◽  
Femoral Artery ◽  
Lower Limb ◽  
Artery Aneurysm ◽  
Deep Femoral Artery ◽  
Deep Femoral Artery Aneurysm

scholarly journals Variability of Lower Limb Artery Systolic–Diastolic Velocities in Futsal Athletes and Non-Athletes: Evaluation by Arterial Doppler Ultrasound

2020 ◽  
Vol 17 (2) ◽  
pp. 570
Author(s):  
Pedro Duarte-Mendes ◽  
Rui Paulo ◽  
Patrícia Coelho ◽  
Francisco Rodrigues ◽  
Vasco Marques ◽  
...  
Keyword(s):  
Doppler Ultrasound ◽  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Popliteal Artery ◽  
Lower Limb ◽  
Vascular Remodeling ◽  
Deep Femoral Artery ◽  
Cross Sectional ◽  
Diastolic Velocity ◽  
The Right

Background: Sports athletes, namely high-intensity practitioners, suffer from vascular remodeling overtime. The purpose of this study was to analyze the systolic and diastolic velocities’ variation between non-athletes and futsal athletes by means of arterial lower limb doppler ultrasound. Additionally, we intended to verify if the velocity variations occur primarily at the systolic or the diastolic level and in which arteries. Methods: Seventy-six young males (mean ± SD: 24.9 ± 2.8 years old) volunteered to participate in this cross-sectional study and were divided into two groups: a futsal athletes group (n = 38; 24 ± 2.78 years) in the central region of Portugal playing on the 2nd national league with the same level of practice (16 ± 2.4 years of practice) and a non-athletes group (n = 38: 26 ± 1.8 years) who did not practice sports regularly and were not federated in any sport. All the subjects agreed to participate in the study with the aim of assessing the arterial lower limb through doppler ultrasound (Philips HD7 echograph with linear transducer 7–12 MHz). Results: Differences between groups (p ≤ 0.05) in the systolic velocity of the left deep femoral artery (p = 0.022; d = 0.546, small) and in the right superficial femoral artery (p = 0.028; d = −0.515, small) were found. We also found differences in the diastolic velocity: in the left common femoral artery (p = 0.002; d = −0.748, moderate), in the right deep femoral artery (p = 0.028; d = −0.521, small), in the right superficial femoral artery (p = 0.026; d = −0.522, small), in the right popliteal artery (p = 0.002; d = −0.763, moderate), and in the left popliteal artery (p = 0.007; d = −0.655, moderate). Moreover, the athletes’ group presented the highest mean values, with the exception of the systolic velocity of the left deep femoral artery. In intragroup analysis of variance referring to systolic and diastolic velocities in arterial levels in the right and left arteries, differences were found in all analyses (p ≤ 0.05). Conclusions: We conclude that futsal athletes of our sample go through a process of changes such as increased blood flow velocity in systolic and diastolic cardiac phase in all studied lower limb arteries, showing that the remodeling occurs regardless of vessel radius. Our results reinforce the existence of vascular remodeling that may vary with the sport and its intensity.

Tensor Fasciae Lata for Groin Reconstruction

2019 ◽  
pp. 811-816
Author(s):  
Peter C. Neligan
Keyword(s):  
Lower Limb ◽  
Abdominal Cavity ◽  
Pedicled Flap ◽  
Fascia Lata ◽  
Circumflex Artery ◽  
Lower Limb Reconstruction ◽  
Lateral Femoral Circumflex Artery ◽  
Neurovascular Structures ◽  
Tfl Flap

Because the groin combines elements of myofascial strength, which influences the integrity of the abdominal cavity, with the role of being a conduit for neurovascular structures to the lower limb, reconstruction demands that the repair be strong as well as provide adequate soft tissue to protect these structures. The tensor fasciae lata (TFL) flap is supplied by the transverse or ascending branch of the lateral femoral circumflex artery. It is usually used as a pedicled flap and reaches the trochanteric area and the groin. It is one of the workhorse flaps for treatment of decubitus ulcers and is very durable. The flap consists of skin and fascia lata. The fascial component can be extended to include more fascia while still allowing closure of the skin donor defect

scholarly journals Osteonecrosis of Femoral Head Occurred after Stent Placement of Femoral Artery

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Akiyoshi Shimatani ◽  
Fumiaki Inori ◽  
Taku Yoshida ◽  
Masahiko Tohyama ◽  
Sadahiko Konishi ◽  
...  
Keyword(s):  
Femoral Head ◽  
Femoral Artery ◽  
Stent Placement ◽  
Endovascular Procedure ◽  
Deep Femoral Artery ◽  
Circumflex Artery ◽  
Arteriosclerosis Obliterans ◽  
Osteonecrosis Of Femoral Head ◽  
Medial Femoral Circumflex Artery ◽  
Inferior Limb

We present a case of osteonecrosis of femoral head (ONFH) that occurred after stent angiography of femoral artery for the treatment of arteriosclerosis obliterans (ASO) of left inferior limb in a 76-year-old woman. No case of late collapse of femoral head as a complication of endovascular procedure such as stent placement has been previously documented. We considered that ONFH occurred after detaining stent at a junction of left deep femoral artery for the treatment of the ischemia of left lateral and medial femoral circumflex artery.

Surgery of the Deep Femoral Artery

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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