Endomyocardial biopsy: indications and procedures
Debabrata Mukherjee, Eric R. Bates, Marco Roffi, Richard A. Lange, David J. Moliterno, Nadia M. Whitehead in Cardiovascular Catheterization and Intervention, 2017
Despite relatively easy cannulation, biopsy from the femoral vein can be challenging.[15] The femoral vein is located medial to the femoral artery and the entry site should be below the inguinal ligament. The Amplatz, Seldinger, or micropuncture techniques may be used for venous access. A guide sheath is introduced into the inferior vena cava (IVC) via the femoral vein. The femoral artery may be accessed in a similar fashion and is the site of entry for most left ventricular biopsy attempts. Left ventricular biopsies, though rare, may be indicated in patients with specific intraventricular masses or isolated left ventricular pathology, such as myocarditis or infiltrative disease.[16] After femoral arterial sheath insertion, a constant infusion of heparinized saline should be maintained through the sheath to prevent thrombus formation within these long catheters.
Invasive hemodynamic monitoring in obstetrics
Hung N. Winn, Frank A. Chervenak, Roberto Romero in Clinical Maternal-Fetal Medicine Online, 2021
Placement of the femoral catheter begins with optimal exposure of the femoral region by externally rotating and abducting the leg away from the midline. The femoral vein is 1 to 2 cm medial to the artery and runs distal to the inguinal ligament. The vein can be located by palpating the pulsating femoral artery. The site must be prepped and draped and the insertion site must be anesthetized with local anesthesia. The introducer needle should then be inserted at a 45’ angle directed along the course of the vein 2 cm below the inguinal ligament (2 cm below an imaginary line that connects the symphysis pubis and the superior–anterior iliac crest). Avoid puncturing above the inguinal ligament since retroperitoneal hemorrhage may ensue. The femoral artery should be palpated at all times while introducing and advancing the needle in an attempt to avoid femoral artery puncture.
Lower limb
David Heylings, Stephen Carmichael, Samuel Leinster, Janak Saada, Bari M. Logan, Ralph T. Hutchings in McMinn’s Concise Human Anatomy, 2017
The femoral triangle is an important region in the upper thigh and is frequently explored surgically. Which of the statements below is anatomically accurate?The femoral artery lies lateral to the femoral nerve beside the femoral canal.The femoral canal is bounded anteriorly by the inguinal ligament and posteriorly by the superior pubic ramus and contains lymphatic channels and nodes.The femoral artery has only one branch in the distal part of the femoral triangle and this is the circumflex femoral artery.The femoral vein lies lateral to the femoral artery and receives the great saphenous vein as its tributary.The femoral nerve lies within the femoral sheath lateral to the femoral vein before it starts to branch distal to the sheath.
Insufficiency of the zona glomerulosa of the adrenal cortex and progressive kidney insufficiency following unilateral adrenalectomy – case report and discussion
Published in Blood Pressure, 2018
Joanna Kanarek-Kucner, Adrian Stefański, Rufus Barraclough, Tomasz Gorycki, Jacek Wolf, Krzysztof Narkiewicz, Michał Hoffmann
After adequate preparation time, including modification of antihypertensive medication and correction of serum potassium, the patient underwent an intravenous saline suppression test (SST) with 2000 ml of 0.9% NaCl. Prior to the infusion, aldosterone was 42 ng/dl and renin was unmeasurable, plasma renin activity (PRA) was 0.01 ng/ml/h, at the end of the test aldosterone was 36.5 ng/dl (<10 ng/dl), indicating inadequate aldosterone suppression. An abdominal CT scan revealed a 15x16 mm thickening of the right adrenal gland possibly suggesting a low lipid content adenoma, however in this and in previous CT scans the radiological view was not typical for PA. Adrenal venous sampling was performed. An hour before the procedure, a continuous intravenous infusion with a synthetic corticotropin was administered. Following this, the suprarenal veins were catheterised via the right femoral vein. The localisation of the catheter was regularly validated by sampling cortisol from the veins. For further analysis, samples with the highest cortisol-based selective index were chosen from the right and left suprarenal vein (13.9 and 7.2, respectively). Aldosterone and cortisol levels from the venous samples were then used to calculate the lateralization index (26.8) and suppression index (0.17).
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.
The Effect of Very Low Concentrations of Ethanol on Microvascular Artery and Vein Anastomosis: An Experimental Study
Published in Journal of Investigative Surgery, 2022
Soysal Bas, Ramazan Ucak, Kurtulus Oz, Semra Hacikerim Karsidag
The mean femoral vein diameters before anastomosis were similar in all groups (p = 0.940). At the fifth and 15th minutes, there was an increase in vein diameters (fifth minute, p = 0.379; 15th minute, p < 0.001). In the third postoperative week, thrombosis and vascular damage were detected in seven veins in Groups IV and V, one vein in Group I, and two veins in Group III. As with the arteries, Groups IV and V were excluded from the diameter assessment. At the 15th minute, the vein diameters were found significantly higher in Groups II (p < 0.001), III (p < 0.001), IV (p < 0.001) and V (p = 0.034) compared to Group I. Although a statistically significant increase was detected in the mean vein diameters in Groups II (p = 0.002) and III (p = 0.001) compared to group I at the third week, there was no difference found between Groups II and III (p = 0.898). Unlike the arteries, vein diameters decreased slightly in the third week compared to the 15th minute (Group I: p = 0.015; Group II: p = 0.44; Group III: p = 0.01; Group IV: p = 0.002; and Group V: p = 0.013) (Table 2).
Related Knowledge Centers
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- Great Saphenous Vein
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- Superficial Vein
- Vein
- Femoral Artery
- Body
- Femoral Sheath
- Deep Vein
- ADDuctor Hiatus