scholarly journals Descriptive cohort study of Ligation of femoral artery in infected femoral pseudoanurysm in injectable drug abuser

2020 ◽  
Vol 1 (1) ◽  
pp. 6-9
Author(s):  
Dinesh Chapagain ◽  
Kiran Prasad Shrestha ◽  
Deepak Thapa Magar ◽  
Kumar Bahadur Shrestha

Background: Infected femoral pseudoanurysm with impending rupture presents most of the time in the late stage in drug abuser with features of sepsis. These cases are managed immediately by exploration with ligation of femoral artery when bypass is not feasible in emergency. Methods: This is the retrospective descriptive study of 11 years of bir hospital. Datas were collected from the record and subsequent out patient department visits of the cases having femoral infected pseudoanurysm with impending rupture with sepsis of injectable drug abuser. The data collected were patients profile, type of procedure like ligation of femoral artery, bypass like reverse long saphenous graft and synthetic dacron or ptfe graft and complications were also recorded with subsequent. The type of procedure were compared with amputation as final end point. Datas were analysed by SPSS softwear. Results: We recorded the datas of 45 patients with almost all were male with very few female having mean age of 27.91 years. Twenty two patients had seropositive status and 13 patients had negative. Thirty five patients had ligation of femoral artery,7 patients had interposition synthetic bypass graft and 3 patients had reversed long saphenous vein graft. Nine patients had undergone revision after graft failure as ligation. No complication in 20 cases .Nine cases had rethrombosis with infection, 7 had minor complication and 1 had severe claudication. Conclusions: In emergency setting, simple ligation of the femoral artery can be both life and limb saving procedure in difficult situation like infection and sepsis.

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
T. Girão-Silva ◽  
M. H. Fonseca-Alaniz ◽  
J. C. Ribeiro-Silva ◽  
J. Lee ◽  
N. P. Patil ◽  
...  

AbstractThe rate of the remodeling of the arterialized saphenous vein conduit limits the outcomes of coronary artery bypass graft surgery (CABG), which may be influenced by endothelial dysfunction. We tested the hypothesis that high stretch (HS) induces human saphenous vein endothelial cell (hSVEC) dysfunction and examined candidate underlying mechanisms. Our results showed that in vitro HS reduces NO bioavailability, increases inflammatory adhesion molecule expression (E-selectin and VCAM1) and THP-1 cell adhesion. HS decreases F-actin in hSVECs, but not in human arterial endothelial cells, and is accompanied by G-actin and cofilin’s nuclear shuttling and increased reactive oxidative species (ROS). Pre-treatment with the broad-acting antioxidant N-acetylcysteine (NAC) supported this observation and diminished stretch-induced actin remodeling and inflammatory adhesive molecule expression. Altogether, we provide evidence that increased oxidative stress and actin cytoskeleton remodeling play a role in HS-induced saphenous vein endothelial cell dysfunction, which may contribute to predisposing saphenous vein graft to failure.


Angiology ◽  
2012 ◽  
Vol 63 (8) ◽  
pp. 622-629 ◽  
Author(s):  
Mohammad Kazem Tarzamni ◽  
Nazanin Eshraghi ◽  
Rohollah Fadaei Fouladi ◽  
Abbas Afrasiabi ◽  
Monireh Halimi ◽  
...  

2021 ◽  
Vol 4 (2) ◽  
pp. 01-12
Author(s):  
Jo Dens

Chronic total occlusion (CTO) desobstruction of a native coronary artery in a post coronary artery bypass graft (CABG) patient can be a challenging procedure. In principle, the 3 basic approaches of recanalization of occluded native coronary arteries can be used: antegrade wire escalation (AWE), antegrade dissection re-entry (ADR) and a retrograde technique. On the other hand, a previous implanted saphenous vein graft (SVG) – even when occluded – can be used as a conduit for retrograde access. Moreover, access through a graft might be less complex compared to the use of septal or epicardial collaterals. If the graft is still open or has a tapered stump, this should be considered as a suitable conduit. Literature on recanalization of occluded native coronary arteries trough a diseased or occluded SVG is limited. A flowchart with an algorithm in post CABG patients is proposed and illustrated by 3 clinical cases.


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