MyMedR

An interconnected duplicated femoral vein and its clinical significance

Khan AA, Asari MA, Hassan A, Aiman N

Folia Morphol (Warsz), 2013 Feb;72(1):82-5.

Anatomical variations in the femoral vein are of great clinical importance especially in cases of deep vein thrombosis (DVT). Knowledge of the variable anatomy of the femoral vein is important to minimise false-negative findings on ultrasound examination in patients with DVT and help to explain the 'silent' DVT. Furthermore, the presence of a duplicated femoral vein itself is associated with higher incidence of DVT. These venous anomalies are usually due to the truncular venous malformation. In the present study, while dissecting the right lower limb, we found a case of variation of the femoral vein. In this case, besides a duplicated femoral vein, we also noticed a 3rd interconnecting channel near the apex of the femoral triangle joining the two veins. This variation has not been reported previously by other authors. Considering its uniqueness and clinical importance, we decided to report this case.

Matched MeSH terms: Femoral Vein/abnormalities*; Femoral Vein/anatomy & histology*

Saphenous Ladder Formed by Almost Completely Duplicated Great Saphenous Vein

Packiriswamy V, Nayak SB

Kathmandu Univ Med J (KUMJ), 2021 2 15;18(69):99-101.

PMID: 33582698

Knowledge of normal as well as variant great saphenous vein is useful as it is the vein that can get varicosed; the vein that is used in bypass surgeries and the vein that is used for cannulation purpose. We observed almost complete duplication of the great saphenous vein in the left lower limb of an adult male cadaver. Both the great saphenous veins arose from the medial end of the dorsal venous arch and coursed parallel to each other throughout the limb. They united in the femoral triangle to form a short (1 inch long) common great saphenous vein. Common great saphenous vein terminated into the femoral vein. There were four communicating veins connecting the two great saphenous veins in the leg, giving the appearance of a venous ladder. Knowledge of this variation could be extremely useful in treatment of varicose veins of lower limb, in catheterizations and in various surgical procedures of the lower limb.

Matched MeSH terms: Femoral Vein

Fulltext Percutaneous central venous catheterisation in critically ill children

Goh AYT, Lum LCS, Chan PWK, Roziah M

Med J Malaysia, 1998 Dec;53(4):413-6.

PMID: 10971986

An 18-month analysis of 52 percutaneously placed central venous catheters in 48 critically ill children was done. Success rate were 91.7% (33/36) and 93.8% (15/16) for femoral and non-femoral catheters respectively. Presence of hypotension (48.1%) and significant coagulopathy (26.9%) did not affect the success rate significantly. Minor bleeding and venous congestion was seen in 5.5% (2/36) of patients with femoral catheters. Infections were found in 2.7% (1/36) of femoral and 6.6% (1/15) of non-femoral catheters. The low incidence of complications and the relative ease of insertion makes the femoral route the preferred site for trainee medical officers in critically ill children when central access is indicated.

Matched MeSH terms: Femoral Vein

Extra-anatomical veno-venous surgical bypass for central vein occlusion in patients with ipsilateral arterio-venous fistula (AVF) for haemodialysis - A single centre experience

Saravana KS, Zainal AA

Med J Malaysia, 2017 02;72(1):3-6.

PMID: 28255132 MyJurnal

OBJECTIVE: Central vein occlusion is a common complication related to central vein catheter insertion for haemodialysis which can be unmasked by an ipsilateral fistula creation, leading to a dysfunctional arteriovenous fistula (AVF). We describe an extra-anatomical venous bypass surgical procedure performed to maintain vascular access and reduce the symptoms of swelling of the ipsilateral upper limb, neck and face.

MATERIALS AND METHODS: We report 20 consecutive patients with end-stage renal failure (ESRF) who had central vein occlusion and were not amenable to endovascular intervention. They underwent extra-anatomical vein to vein surgical bypass. The axillary and iliac or femoral veins were approached via infraclavicular and extraperitoneal groin incisions respectively. In all the patients, an externally supported 6 or 8 mm polytetrafluoroethylene (PTFE) graft was used as a conduit and was tunnelled extra-anatomical. All patients had double antiplatelet (Aspirin and Clopidogrel) therapy post-operatively.

RESULTS: Substantial improvement in the facial, neck and upper limb swelling was noticed following this diversion surgery. The vein to vein bypass was patent at 12 months in 10 out of 20 patients. Graft infection occurred in two (10%) cases. Re-thrombectomy or assisted patency procedure (stent/plasty) was done in four (20%) cases. The patients with preoperative fistula flow rate of more than 1500 ml/min and post-operative graft flow rate of more than a 1000 ml/min were patent at 12 months (P=0.025 and p=0.034 respectively).

CONCLUSION: Axillary to iliac/femoral vein bypass can salvage functioning ipsilateral fistula threatened by occluded upper central vein.

Matched MeSH terms: Femoral Vein

Fulltext Embolisation of External Jugular Vein Aneurysm: A Case Report

Rajadurai A, Aziz AA, Daud NAM, Wahab AFA, Muda AS

Malays J Med Sci, 2017 Dec;24(6):107-112.

PMID: 29379394 DOI: 10.21315/mjms2017.24.6.14

Introduction: Venous aneurysms are not as common as their arterial counterpart. The choice of management is debatable. Case Report: We present the case of a teenage boy with left external jugular vein aneurysm treated by endovascular technique. Embolisation was done using pushable microcoils with access via the femoral vein and direct puncture.

Conclusion: This form of treatment provides a less-invasive option with a more concrete evaluation of the venous abnormality and its drainage during venous aneurysm occlusion.

Matched MeSH terms: Femoral Vein

Fulltext "Fishing for lines": removal of endovascular catheters from the cardiovascular system

Wong AR, Suhaimi H, Ridzuan MA, Rizal MM, Saedah A

Singapore Med J, 2009 Oct;50(10):e358-61.

PMID: 19907875

We present two infants whose endovascular lines were accidentally cut or fractured, and had to be retrieved via transcatheter means in the cardiac catheterisation laboratory. The first case was a two-month-old infant with transposition of the great arteries, requiring an emergency balloon atrial septostomy. An indwelling vascular catheter that was placed in the right femoral vein was accidentally cut and had migrated into the inferior vena cava, before being retrieved. The second case was a one-week-old neonate who presented with pneumonia at birth, and had a long intravenous catheter placed in the left saphenous vein, which became fractured, and subsequently migrated into the heart. This case presented as a pulmonary embolus with haemodynamic instability, as the catheter had partially obstructed the right ventricular outflow tract. This was later retrieved via transcatheter means.

Matched MeSH terms: Femoral Vein/surgery

Fulltext Clinics in diagnostic imaging (23). Traumatic rupture of the left iliac vein

Ram SP, Kassim Z, Kyaw K, Haque E, Halder D

Singapore Med J, 1997 Mar;38(3):134-5.

PMID: 9269385

A 3-day-old male baby with neonatal necrotising enterocolitis had a central line (Cavafex No. 18) inserted through the left femoral vein for administration of parenteral nutrition. Forty-eight hours later, he developed progressive abdominal distention with evidence of free abdominal fluid. A contrast injection done through the left femoral vein revealed retroperitoneal leakage of contrast from a traumatic rupture of the left iliac vein. The intravenous catheter was removed and he was treated conservatively with eventual recovery.

Matched MeSH terms: Femoral Vein

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