Anatomic relationship between the common femoral artery and vein: CT evaluation and clinical significance.

Baum, Phillip A.; Matsumoto, Alan H.; Teitelbaum, G P; Zuurbier, Rebecca A.; Barth, Klemens H.

doi:10.1148/radiology.173.3.2813785

Cited by 64 publications

(43 citation statements)

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“…Femoral veins Anatomy Demonstrated with pelvic computed-tomography scans, in the saggital plane a portion of the FV is overlapped by the femoral artery in 65% of patients [20]. This finding was confirmed by US scans of 50 patients [21].…”

Section: Risks and Complicationsmentioning

confidence: 78%

US-guided peripheral vascular interventions, comments on the EFSUMB guidelines

Dietrich

Horn²,

Morf

et al. 2016

Med Ultrason

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Peripheral venous as well as arterial punctures have traditionally been performed on the basis of designated anatomical landmarks. However, due to patients' individual anatomy and vessel pathology and depending on individual operators' skill, this landmark approach is associated with a significant failure rate and complication risk. This review comments on the evidence-based recommendations on ultrasound (US)-guided vascular access which have been published recently within the framework of Guidelines on Interventional Ultrasound (INVUS) of the European Federation of Societies for US in Medicine and Biology (EFSUMB) from a clinical practice point of view. Part 1 of the review had its focus on general aspects of USguidance and on central venous access, whereas part 2 refers to peripheral vascular access.

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Section: Risks and Complicationsmentioning

confidence: 78%

US-guided peripheral vascular interventions, comments on the EFSUMB guidelines

Dietrich

Horn²,

Morf

et al. 2016

Med Ultrason

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“…Previous vascular studies have attempted to characterize these variables, with specific attention to the concept of overlap. [5][6][7][8] These investigations have provided limited quantitative information about the amount of overlap, however, and did not examine the amount of exposed vein. The amount of exposed femoral vein is arguably the most important factor in determining the success of central venous access.…”

Section: Ré Sumémentioning

confidence: 99%

Bedside ultrasonography detects significant femoral vessel overlap: implications for central venous cannulation

Beaudoin

Merchant

Lincoln

et al. 2011

CJEM

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Objective: Our goal was to gain a better understanding of the femoral vessel anatomy as it relates to central venous cannulation. The primary objective of this study was to use bedside ultrasonography to determine the amount of exposed femoral vein at three sites corresponding to surface anatomy of the landmark-based procedure. Methods: This cross-sectional study enrolled a random sample of 180 adult patients presenting to a large urban academic emergency department. Subjects underwent standardized ultrasonography to identify and measure the depth and diameter of the femoral vessels and amount of exposed femoral vein at the level of the inguinal ligament (0 cm) 2 cm and 4 cm below. Repeated measures analysis of variance was used to determine significant relationships between vessel measurements and distance from the inguinal ligament. Results: The median age was 44.5 (range 19-90) years; 101 patients were male. The mean (6 SD) percentage of exposed vein at the inguinal ligament was 83% (6 21). This decreased significantly (p , 0.01) with increasing distance from the inguinal ligament: 65% (6 25) at 2 cm and 56% (6 30) at 4 cm. At every distance away from the inguinal ligament, there were some subjects with no vein exposed. Conclusion: This study demonstrates significant overlap of the femoral vessels at sites where landmark-based femoral vein cannulation is often attempted. Our results suggest that ultrasound guidance would be beneficial as femoral vein cannulation may be difficult or impossible in certain individuals owing to anatomic variations. RÉ SUMÉObjectif: Notre objectif é tait d'acqué rir une meilleure compré hension de l'anatomie des vaisseaux fé moraux en ce qui concerne la canulation veineuse centrale. L'objectif principal de cette é tude é tait d'utiliser l'é chographie au chevet pour dé terminer la portion de la veine fé morale exposé e à trois points correspondant à l'anatomie de surface en utilisant la technique des points de repè res. Mé thodes: Dans le cadre de cette é tude transversale, un é chantillon alé atoire, composé de 180 adultes qui se sont pré senté s au service d'urgence d'un grand centre universitaire en milieu urbain, a é té utilisé . Les sujets ont subi une é chographie standardisé e pour dé tecter et mesurer la profondeur et le diamè tre des vaisseaux fé moraux et la portion de veine fé morale exposé e au niveau du ligament inguinal (à 0 cm), à 2 cm et à 4 cm en-dessous. Une analyse de variance à mesures ré pé té es a é té effectué e pour dé terminer les relations significatives entre les mesures des vaisseaux et la distance entre la veine et le ligament inguinal. Ré sultats: L'â ge mé dian é tait de 44,5 ans (fourchette de 19 à 90 ans); 101 patients é taient de sexe masculin. La moyenne (6 s) en pourcentage de la veine exposé e au ligament inguinal é tait de 83 % (6 21). Cela diminuait de faç on significative (p ,0,01) avec l'augmentation de la distance la sé parant du ligament inguinal : de 65 % (6 25) à 2 cm et de 56 % (6 30) à 4 cm. À chaque point distant du ligament ...

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“…Reviewing CT scans of the pelvis in 100 patients, Baum et al . [10] discovered that a portion of the FV and the femoral artery overlaps in the anteroposterior plane 65% of the time. A subsequent study,[11] which used ultrasound in 50 ICU patients confirmed this finding: “in most patients there was overlap of the artery over the vein far closer to the inguinal ligament than conventional anatomical textbooks would indicate” It is easiest to locate the structures by placing the probe in the transverse plane, depth settings may need to be increased to five or more centimeters in obese patients.…”

Section: Direct Vision Approach (Real Time Ultrasound Guidance)mentioning

confidence: 99%

Postgraduate educational pictorial review: Ultrasound-guided vascular access

2010

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Over the last few years the role of ultrasound has steadily increased and has now an established role in anesthesia and critical care. The various applications of this technology in this field include ultrasound-guided insertion of central lines (internal jugular, subclavian, axillary, femoral) and peripheral venous catheters, arterial line insertion, regional blocks etc. The simple reason of using this technology is “You believe what you see”. In this text we will mainly focus on central line, peripheral venous placement and arterial blood flow patterns under ultrasound guidance.In our institution at KFMC, internal jugular vein cannulation is preferred to cannulation of the subclavian vein because of the higher incidence of pneumothorax and subclavian artery puncture associated with the later. The incidence of carotid artery puncture is higher in children younger than five years than in older children during this procedure. The use of ultrasonography has been shown to increase the success rate and decrease the incidence of complications associated with IJV cannulation in adults.We will go through a stepwise approach in identifying and confirming the required blood vessels for ultrasound-guided cannulation using B-mode (2D), color flow doppler and Pulse Wave Doppler

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Anatomic relationship between the common femoral artery and vein: CT evaluation and clinical significance.

Cited by 64 publications

References 0 publications

US-guided peripheral vascular interventions, comments on the EFSUMB guidelines

US-guided peripheral vascular interventions, comments on the EFSUMB guidelines

Bedside ultrasonography detects significant femoral vessel overlap: implications for central venous cannulation

Postgraduate educational pictorial review: Ultrasound-guided vascular access

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