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Superficial Femoral Artery (superficial + femoral_artery)
Selected AbstractsSubcutaneous Transposition of the Superficial Femoral Artery for Arterioarterial Hemodialysis: Technique and ResultsARTIFICIAL ORGANS, Issue 12 2008Octavio J. Salgado Abstract We report the use of subcutaneous transposition of the femoral artery (STFA) for placement of both inflow and outflow needles in 14 hemodialysis (HD) adult patients with difficult access. Follow-up time was 318 months during which a total of 3215 arterioarterial HD sessions were done. Kt/V values ranged between 0.71 and 1.59. Elevated access recirculation and dialysis outflow pressures were common findings to all patients. Complications were: (i) two episodes of bleeding secondary to puncture-related arterial wall laceration, repaired by stitching; (ii) three episodes of thrombosis in two patients, all successfully declotted; (iii) three puncture-related complications needing placement of a vein interposition graft, namely, aneurysm, pseudoaneurysm, and arterial stenosis; and (iv) one case of arterial ligation because of suppurative puncture site infection, without subsequent distal ischemia signs or claudication. The use of STFA should only be reserved for patients in urgent need for vascular access with no remaining options. [source] Sonographic measurements of subcutaneous fat in obese individuals may correlate better with peripheral artery disease indicesJOURNAL OF CLINICAL ULTRASOUND, Issue 5 2009Serafim Tsitsilonis MD Purpose. The purpose of this study was to investigate the association of various methods for body fat assessment with indices of peripheral artery disease in the deep and superficial femoral arteries. Methods. The intima,media thickness (IMT), maximal IMT (max IMT), femoral wall thickness (FWT), maximal FWT (max FWT), cross-sectional intima media area (CIMA), and atherosclerotic burden score (ABS) were measured sonographically in 26 subjects. The minimum thickness of the abdominal subcutaneous fat layer (Smin) was measured sonographically close to the xyphoid process, and body fat percentage was calculated using various formulas. Results. Smin correlated significantly with body fat percentage calculated with all formulas and was the sole parameter that was associated significantly with all the femoral artery atherosclerotic indices IMT: r = 0.74, p < 0.001; max IMT: r = 0.53, p < 0.05; FWT: r = 0.78, p < 0.001; max FWT: r = 0.57, p < 0.005; ABS: r = 0.52, p < 0.05; CIMA: r = 0.86, p < 0.001; Smin was the major independent predictor of femoral IMT on a multiple stepwise regression analysis (, = 0.02; SE = 0.008, R2 = 0.35, p < 0.05). Conclusions. Smin correlates better than indirect indices and formulas of body fat estimation with markers of extracoronary atherosclerosis. Sonographic measurement of Smin may serve in the future as a useful tool in everyday clinical practice. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound, 2009 [source] Relationship between vascular calcification, arterial stiffness and bone mineral density in a cross-sectional study of prevalent Australian haemodialysis patientsNEPHROLOGY, Issue 1 2009NIGEL D TOUSSAINT SUMMARY Background: Cardiovascular disease in dialysis patients is associated with increased vascular calcification (VC) and arterial stiffness, both inversely correlated with bone mineral density (BMD). Few studies have correlated VC in the dialysis population with measurements of BMD and arterial compliance. Methods: We report cross-sectional data on 45 haemodialysis (HD) patients assessing the prevalence of VC and its associations. Patients had computed tomography scans through abdominal aorta and superficial femoral arteries (SFA) to determine VC, pulse wave velocity (PWV) using SphygmoCor device measuring arterial stiffness, and dual-energy X-ray absorptiometry (DXA) to determine BMD. Results: Patients, 64% male, 38% diabetic, had median age 58 years. Mean PWV was 8.7 ± 3.5 m/s and median aortic VC score 488.1 ± 298 Hounsfield units, with 91% having aortic VC present. In univariate linear regression analysis, aortic VC correlated positively with length of HD (P = 0.03) and diabetes (P = 0.06). Increasing PWV was positively associated with age (P = 0.001), diabetes (P = 0.05) and VC (aortic P = 0.08, SFA P = 0.01). In multivariate regression analysis, length of HD and diabetes were significantly associated with aortic VC, whereas age and diabetes were associated with SFA VC and PWV. Mean lumbar spine and femoral neck T-scores on DXA were 0.14 and ,1.66 respectively. Conclusion: Increased VC and reduced arterial compliance, both closely related, are common in Australian HD patients. Both are associated with diabetes and increasing age, and greater aortic VC is seen with longer duration of dialysis. [source] A Simple Technique of Distal Limb Perfusion During Prolonged Femoro-Femoral CannulationJOURNAL OF CARDIAC SURGERY, Issue 2 2006Navid Madershahian M.D. A serious complication of prolonged femoral cannulation remains the ischemic injury of the distal limb. Subjects: To minimize the incidence of ischemia in the cannulated leg, we have begun to provide antegrade femoral blood flow by placing a vascular introducer percutaneously distal to the arterial cannula into the superficial femoral artery and connecting it to the side port of the arterial line. Conclusion: This technique of distal limb perfusion was found to be safe and effective in preventing lower limb ischemia for patients with prolonged femoral cannulation for extracorporeal circulatory support. [source] Superficial femoral artery occlusive disease severity correlates with MR cine phase-contrast flow measurementsJOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 3 2006Kiyarash Mohajer MD Abstract Purpose To evaluate how cine phase-contrast (PC) flow data correlate with the severity of peripheral vascular disease (PVD). Materials and Methods Flow waveforms were obtained in 48 patients proximal and distal to superficial femoral artery (SFA) disease using the 2D cine PC technique with velocity encoding (venc) = 100 cm/second. Flow data were correlated with SFA disease severity and compared with data from nine healthy volunteers. Results Of 96 arterial segments in 48 patients, 26 were patent or only mildly stenotic, 35 had moderate-to-severe stenosis, and 35 were occluded. The flow patterns tended to become low-resistant below severe stenoses or occlusion. The mean peak flow velocity above/below SFA lesions was significantly higher in patients with severe disease (1.9 ± 1.0, P = 0.01) or occlusion (2.0 ± 1.0, P = 0.003) compared to normal volunteers (1.4 ± 0.6). The delay in peak velocity below the lesions showed a significant positive correlation with lesion severity (r = 0.65, P < 0.001). The mean flow volume ratio above/below SFA lesions was greater in patients with occluded vessels compared to normal volunteers (3.9 and 2.3 respectively; P = 0.04). Conclusion Cine PC flow waveform changes across atherosclerotic lesions correlate with disease severity. This may help determine which lesions are hemodynamically significant. J. Magn. Reson. Imaging 2006. © 2006 Wiley-Liss, Inc. [source] Assessing arterial blood flow and vessel area variations using real-time zonal phase-contrast MRIJOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 3 2006Markus Oelhafen PhD Abstract Purpose To measure peripheral artery function using a real-time phase-contrast (PC)-MRI sequence with tailored image-processing algorithms for flow computation. Materials and Methods An approach to real-time flow measurements was developed based on two-dimensional spatially selective excitation pulses and consecutive tailored processing of the data to derive blood flow and vessel area variations. The data acquisition strategy allows for flow measurements at high spatial and temporal resolutions of 1 mm2 and 50 msec, respectively. In postprocessing the vessel area is automatically extracted using correlation measures in conjunction with morphological image operators. By means of in vitro and in vivo validations, it is shown that the current methods provide accurate and reproducible measurements of flow and vessel area variations. Results In vitro the comparison between the lumen area measured with the presented method and the values obtained by calliper gauge measurement showed a difference of 3.4% ± 3.4% (mean ± 2 SD). Similarly, the comparison between the stroke volumes determined with the presented method and by stopwatch and bucket measurements yielded a difference of 6.1% ± 2.1%. In vivo the results from the real-time measurements for lumen area and stroke volume were compared with those from a gated PC-MRI technique with differences of 4.8% ± 14% and 3.0% ± 24.7%, respectively. Conclusion The presented method constitutes a reliable tool set for quantifying the variations of blood flow and lumen area in the superficial femoral artery during reactive hyperemia and for studying their correlation with cardiovascular risk factors. J. Magn. Reson. Imaging 2006. © 2006 Wiley-Liss, Inc. [source] Case,control comparison of profundaplasty and femoropopliteal supragenicular bypass for peripheral arterial disease,BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 3 2010A. Koscielny Background: The aim of this study was to compare preoperative and postoperative findings, and clinical progress in patients with peripheral arterial occlusive disease undergoing femoropopliteal supragenicular bypass or profundaplasty in a case,control study. Methods: Between January 2001 and June 2004, 171 patients with occlusion of the superficial femoral artery underwent surgery. A retrospective analysis of 28 matched patient pairs was performed. Endpoints were bypass occlusion, surgical revision, amputation and death. Mean length of follow-up was 36 months. Results: At 3 years after surgery there was no statistically significant difference in outcome between femoropopliteal bypass surgery and profundaplasty. There was a trend towards improved results in patients who had bypass surgery for critical leg ischaemia. Preoperative patency of the crural outflow arteries was an independent prognostic factor in multivariable analysis. Conclusion: There were no significant outcome differences between supragenicular bypass surgery or profundaplasty in patients who had surgery for intermittent claudication or ischaemic rest pain. Patients with a single patent tibial artery and gangrene or ulceration appeared to benefit more from bypass surgery. Copyright © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source] Incomplete cellular depopulation may explain the high failure rate of bovine ureteric graftsBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 5 2008J. I. Spark Background: The aim was to assess the results of a decellularized bovine ureter graft (SynerGraft®) for complex venous access. Methods: Bovine ureter conduits were implanted in patients with a failed fistula or access graft in whom native vessels were unsuitable as conduits. Graft histories were obtained from all patients who had undergone this procedure at one institution. Failed grafts were explanted and subjected to histological examination. A sample of fresh bovine ureter was immunostained for galactose (,1 , 3) galactose (,-Gal). Results: Nine patients with a median age of 46 (range 25,70) years underwent complex venous access surgery between August 2004 and November 2006 using a SynerGraft®. Graft types included loop superficial femoral artery to stump of long saphenous vein (four patients), loop brachial artery to vein (two), brachial artery to axillary vein (two) and left axillary artery to innominate vein (one). Three grafts developed aneurysmal dilatation and two thrombosed. Histological assessment of the explanted bovine ureters revealed acute and chronic transmural inflammation. Immunostaining of fresh bovine ureter suggested residual cells and the xenoantigen ,-Gal. Conclusion: Graft failure with aneurysmal dilatation and thrombosis in complex arteriovenous conduits using bovine ureter may be due to residual xenoantigens. Copyright © 2008 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source] | ||||||||||