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20 Papers for FRCS (Plus a Few More)
Published in James Michael Forsyth, How to Be a Safe Consultant Vascular Surgeon from Day One, 2023
Patients randomised to compression plus surgery were offered superficial venous surgery guided by findings on duplex scans. Patients with reflux at the saphenofemoral junction or long saphenous vein were offered saphenofemoral junction disconnection, stripping of the long saphenous vein to below the knee, and calf varicosity avulsions.
Vascular surgery
Published in Kaji Sritharan, Jonathan Rohrer, Alexandra C Rankin, Sachi Sivananthan, Essential Notes for Medical and Surgical Finals, 2021
Kaji Sritharan, Jonathan Rohrer, Alexandra C Rankin, Sachi Sivananthan
Dilated, tortuous and elongated superficial veins. Commonly affects the long saphenous vein (LSV) (» 90%) due to incompetence at the saphenofemoral junction (SFJ); the short saphenous vein (SSV) due to incompetence at the saphenopopliteal junction (SPJ) and rarely in isolation, the calf perforator veins. More common in women, often presenting after pregnancy.
Anatomy of the Anterior Abdominal Wall
Published in Jeff Garner, Dominic Slade, Manual of Complex Abdominal Wall Reconstruction, 2020
The venous drainage of the abdominal wall follows the arteries, but the anastomoses between the veins are more developed than for the arterial supply, particularly in disease states. In addition there is a plexus of veins sitting within the dermis of the anterior abdominal wall which drain into the superior and inferior superficial epigastric veins. The superior superficial epigastric veins pass upward through the subcutaneous tissue of the thorax to drain into the cephalic and jugular veins. The inferior superficial epigastric veins pass down to the groin and drain into the saphenous vein just proximal to the sapheno-femoral junction. Disease states may also open collateral veins between these superficial veins and the portal vein; these collaterals run within the falciform ligament. In this case these veins will be tortuous, be under high pressure and have high flow within them (Figure 1.7).
Sentinel lymph node biopsy based on anatomical landmarks and locoregional mapping of inguinofemoral sentinel lymph nodes in women with vulval cancer: an operative technique
Published in Journal of Obstetrics and Gynaecology, 2023
Fong Lien Kwong, Miski Scerif, Jason KW Yap
Surgical technique: We start by identifying the anterior superior iliac spine and pubic tubercle to map the course of the inguinal ligament. We then palpate the femoral artery to identify its location and a handheld Doppler may be used in obese women. Situated on its medial side in the femoral triangle is the femoral vein and the latter is joined on its medial side by the saphenous vein at the saphenofemoral junction. We make a 3-4cm incision inferior to and parallel to the inguinal ligament. The incision extends over the femoral vein and slightly above the saphenous vein (Figure 1). Radiolocalisation of the SLN was achieved after identifying and excising the node with the highest signal count using a handheld gamma counter. The groin was re-examined and dissection continued until there was no residual radioactivity. All histological specimens were analysed using ultrastaging with immunohistochemistry. Ipsilateral unilateral inguinal SLN biopsies were conducted for lateral tumour and bilateral excisions for central tumours. The long saphenous vein was preserved in all cases.
Management of out-of hospital cardiac arrest patients with extracorporeal cardiopulmonary resuscitation in 2021
Published in Expert Review of Medical Devices, 2021
Christopher Gaisendrees, Matias Vollmer, Sebastian G Walter, Ilija Djordjevic, Kaveh Eghbalzadeh, Süreyya Kaya, Ahmed Elderia, Borko Ivanov, Stephen Gerfer, Elmar Kuhn, Anton Sabashnikov, Heike a Kahlert, Antje C Deppe, Axel Kröner, Navid Mader, Thorsten Wahlers
Ultrasound-guided punctuation of the femoral artery and vein should be performed whenever possible. At the catheterization laboratory, the punctuation of the vessels is guided via x-ray. In situations of ongoing CPR, the localization and verification of the femoral vessels is more challenging, compared to other VA-ECMO-cannulation scenarios. This is mainly due to ongoing chest compressions and deoxygenated blood, which increases the difficulty in verifying the right vessel. Therefore, echocardiographic verification becomes increasingly important, since local complications of blind punctuation consist of inadvertent arterial puncture, saphenofemoral junction cannulation, and transifaxtion of inguinal ligament during cannulation [17,18].Non-visualized techniques of insertion may result in steep or off-center penetration of the vessel that can make subsequent dilation more difficult and increases the risk of vessel perforation or kinking of the guidewire.
What is the optimal treatment technique for great saphenous vein diameter of ≥10 mm? Comparison of five different approaches
Published in Acta Chirurgica Belgica, 2021
Emre Kubat, Celal Selçuk Ünal, Onur Geldi, Erdem Çetin, Aydın Keskin
Data of the patients were obtained from the hospital automation system and patient files. The degree of preoperative venous insufficiency was evaluated by the vascular surgeon according to the CEAP classification and Venous Clinical Severity Score (VCSS). The duration of GSV insufficiency and vein diameter were assessed using Doppler ultrasonography (DUS). Pathological venous reflux was defined as a reverse flow for longer than 0.5 s in response to the release calf in the standing position and after a valsalva maneuver in the supine position. The vein diameter was measured from 3 cm below the saphenofemoral junction (SFJ) and knee.