An unexpected anatomical variant of the femoral artery in a patient with acute lower limb ischemia: case report (original) (raw)
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World journal of clinical cases, 2015
The anatomical knowledge of arterial variations of lower limb is of utmost significance for the present day surgeons and interventional radiologists for minimizing complications during vascular reconstructive procedures, catheterization procedures and surgical intervention for embolism. Lateral Circumflex Femoral Artery (LCFA) is an important branch of Profunda Femoris artery and precise knowledge of its variations can be of great relevance during surgical and radiological procedures in femoral region. The present study reports a unique case of anomalous route taken by LCFA posterior to femoral nerve associated with a prominent muscular branch from Femoral artery mimicking the course of LCFA. Documentation of such variations is highly significant. It may serve as guideline for surgeons in reducing the incidence of postoperative complications where LCFA is used as a long vascular pedicle in anterolateral perforator thigh flap and in breast reconstruction after mastectomy. Ignorance o...
Complication inhabituelle d’une embolectomie fémorale « Aveugle »
Annales de Chirurgie Vasculaire, 2010
Les faux an evrysmes iatrog enes apr es embolectomie f emorale sont rares et ont et e d ecrits dans les art eres poplit ee, tibiale post erieure, et p eroni ere. Nous pr esentons un cas peu commun d'un tel faux an evrysme provenant d'une collat erale g enicul ee sup erieure m ediale qui naissait de l'art ere poplit ee proximale a angle aigu. Il est probable que le cath eter d'embolectomie ait accidentellement p en etr e dans cette branche, qui s'est rompue quand le ballon a et e gonfl e. L'embolisation transluminale par spires a eu comme cons equence la thrombose r eussie du faux an evrysme.
External Iliac Artery to Tibial Arteries Vein Graft for Inaccessible Femoral Artery
Annals of Vascular Surgery, 2019
Background: An endovascular-first approach to limb salvage and relief from lifestyle-limiting claudication is widely accepted. Stenosis or short occlusion of common, superficial femoral, and popliteal arteries can be corrected with percutaneous transluminal angioplasty (PTA) with stent positioning. Patency rates of these procedures are limited. We report our experience with external iliac artery to the infrapopliteal vessels vein grafts when the endovascular treatment fails. Methods: Between January 2013 and January 2019, 16 patients (16 limbs) were operated on for limb-threatening ischemia after the occlusion of PTA with stent positioning of the common, superficial femoral, and popliteal arteries. Three patients were treated at our hospital by interventional radiologists; the remaining were operated on elsewhere. An external iliac artery to the infrapopliteal vessels vein bypass graft was anatomically interposed to restore blood flow. End points of the study were death-related events, vein graft failure, and major (above-or below-knee amputation) or minor (foot or toe amputation) limb loss. Results: There were 12 men and 4 women. Mean age of patients was 68 years. Indication for the initial PTA with stent positioning of the common and superficial femoral artery was according to the Rutherford classification Grade I: Category 1, 11 patients (69%) and Category 2, 5 (31%) patients (Stage IIa and IIb according to Fontaine classification, respectively). Great saphenous vein was used in 14 (87%) cases and in 2 (13%) cases a composite graft with a segment of cephalic vein was required. The distal anastomoses were performed on the posterior tibial artery in 6 (37%) cases, anterior tibial artery in 4 (26%), and peroneal artery in 6 (37%). Four-year survival and primary patency rates were 71% (standard error [SE] ¼ 0.15) and 73% (SE ¼ 0.14), respectively. One graft occlusion required an above-knee amputation. Four-year limb salvage rate was 86% (SE ¼ 0.13). Discussion: We recommend the external iliac artery as source of inflow in patients in whom the vein bypass cannot originate from the common femoral or from a more distal inflow source because of previous PTA with stent positioning or it is deemed hazardous.
Vascular Disease Prevention, 2008
Spontaneous isolated dissection of the iliac artery (SID-IA) is a rare pathologic condition. The predisposing factors and best treatment strategies are still being debated. We present the case of a 59-year-old male with acute right lower limb ischemia characterized by the sudden occurrence of rest pain, hypoesthesia, and paresis. Angiography showed SID-IA extending down to the femoral bifurcation. The patient had no risk factors for SID-IA; however, he survived an electrocution and had arterial hypertension at admission. Endovascular revascularization was successfully performed, with complete restoration of limb blood flow and remission of symptoms. Follow-up ultrasonography at 1 year confirmed stent patency and absence of clinical symptoms. Endovascular stenting is a good therapeutic option for symptomatic SID-IA without rupture.
Spontaneous Superficial Femoral Artery Dissection with Distal Embolization
Annals of Vascular Surgery, 2002
Primary arterial dissection of the peripheral vessels is a rare condition. We report a case of spontaneous dissection of the distal superficial femoral artery compounded by distal embolization leading to ischemic symptoms. The patient was successfully treated with exploration of the superficial femoral artery over the area of the dissection, distal embolectomy, and reconstruction by way of an interposition graft. Awareness of this condition leads to potentially earlier diagnosis and expands the therapeutic options.
Angiography and Therapeutic Embolisation of Bleeding Aberrant Iliac Artery Branches
Journal of the College of Physicians and Surgeons Pakistan
A 78-year female presented with the complain of per rectal fresh bleeding for 4 days. She was known to have diabetes and hypertension, 3 weeks back. She had an episode of left middle cerebral artery (MCA) stroke. After stroke, she suffered from upper limb weakness and aphasia. At the time of presentation, her vitals showed blood pressure of 118/52 mmHg, O 2 saturation of 98%, temperature: 37°C, respiratory rate (RR) of 20/min, and heart rate (HR) of 90 bpm. After achieving hemodynamic stability, she was transferred to radiology department. Her presenting complain of active rectal bleeding was managed by interventional radiologist using angiographic embolisation. In this patient, it was found pooling of blood in a retrograde fashion in the sigmoid colon. Bleeding was initially believed to be coming from sigmoid arteries seen on images of CT scan and colonoscopy. However, arteriography showed that source of bleeding was from middle and inferior rectal arteries that originated from left internal iliac artery. The intervention radiology (IR) team had to put in extensive effort to locate and perform therapeutic embolisation.
Iatrogenic Iliofemoral Vein Dissection: A Rare Complication of Femoral Artery Puncture
Vascular and Endovascular Surgery, 2018
Iatrogenic iliac vein dissection secondary to femoral artery puncture is a rare complication that has not yet been documented. A 55-year-old woman presented to our institution with acute right iliofemoral thrombosis 2 weeks after transfemoral cerebral angiography. She was previously healthy and was not taking any medication. Right iliofemoral vein dissection was diagnosed by computed tomography angiography and confirmed by conventional venography. The patient was treated endovascularly with stent insertion, and the venous outflow was patent on the 6-month follow-up computed tomography angiogram.
EJVES Extra, 2005
A 50-year-old, male patient with a known left post-thrombotic syndrome presented with giant limb oedema and a large femoral arteriovenous fistula. The patient was unable to walk. Due to hostile local tissue conditions, we decided to perform an endovascular treatment. Because of severe angulation and tortuosity of the left common iliac artery, a combined procedure with retroperitoneal exposure of the external iliac artery was necessary. A reversed tapered limb of an aortic stent-graft (20! 16!10 cm 3 , Excluder, Gore) was introduced into the femoral artery and deployed just below the orifice of left profunda femoris. Intraoperative and post-operative angiography revealed the successful seal of the fistula and patency of femoral and distal arteries. The patient was ambulated on the 2nd post-operative day, and 10 months later shows significant clinical improvement.