Ultrasonography of the femoral vessels in the groin: implications for vascular access

Hughes, Pamela J.; Scott, Carla K.; Bodenham, A.

doi:10.1046/j.1365-2044.2000.01615-2.x

Cited by 64 publications

(41 citation statements)

References 18 publications

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“…Also, an anatomic variation more common in women places the femoral artery and circumflex branches overtop the femoral vein which may increase the risk of accidental arterial puncture. 18, 21, 22 …”

Section: Discussionmentioning

confidence: 99%

Relation of Morbid Obesity and Female Gender to Risk of Procedural Complications in Patients Undergoing Atrial Fibrillation Ablation

Shoemaker

Muhammad

Farrell

et al. 2013

The American Journal of Cardiology

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Obese patients with atrial fibrillation (AF) are frequently managed with AF ablation. We sought to examine whether there exists a body mass index (BMI) threshold beyond which odds of experiencing a complication from AF ablation increase. All patients enrolled in the Vanderbilt AF Registry who underwent catheter-based AF ablation from May 1999 to February 2012 were included. Major complications were recorded. Morbid obesity was defined as BMI >40 kg/m2, and BMI as a continuous variable was examined in multivariable analysis. Thirty-five complications (6.8%) occurred in 512 ablations. Morbidly obese patients experienced a higher rate of complications (6/42, 14.3%) than non-morbidly obese (29/470, 6.2%) (P=0.046). Using a discrete BMI cut-off, the odds of complications increased 3.1-fold in those with morbid obesity (odds ratio [OR] 3.1, 95% Confidence Interval [CI] 1.1–8.4, P=0.03) and 2.1-fold by female gender (OR 2.1, 95% CI 1.04–4.38, P=0.04). With BMI as a continuous variable, the odds of complications increased by 5% per 1 unit increase in BMI (OR 1.05, 95% CI 1.0–1.11, P=0.05) and there was a 2.2-fold increase by female gender (OR 2.2, 95% CI 1.1–4.6, P=0.03). In conclusion, morbid obesity represents a BMI threshold above which the odds of complications with AF ablation significantly increase. The increase in complications appears to be driven primarily by events in women suggesting that morbidly obese women are a special population to consider when considering AF ablation.

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Section: Discussionmentioning

confidence: 99%

Relation of Morbid Obesity and Female Gender to Risk of Procedural Complications in Patients Undergoing Atrial Fibrillation Ablation

Shoemaker

Muhammad

Farrell

et al. 2013

The American Journal of Cardiology

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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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“…This filter successfully removes any high frequency noise and attenuates the arterial pressure wave signal (i.e. the femoral artery and vein cross in some instances [7], [8]), while preserving important signal information.…”

Section: A System Designmentioning

confidence: 99%

A dynamic compression system for improving ulcer healing: Design of a sensing garment

Hegarty

Grant

Reid³

et al. 2008

2008 IEEE International Conference on Multisensor Fusion and Integration for Intelligent Systems

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Venous leg ulcers remain a major problem in the United States, with spending reaching upwards of $1 billion annually. Current treatment options center around the use of compression therapy, which is often delivered in the form of compression bandages, medical-grade stockings, or pneumatic devices. These technologies suffer from a lack of adaptability and/or portability, which may cause inefficient healing. A potential solution to this problem involves the use of an intelligent system that can vary the amount of compression delivered based upon measured physiological variables. A sensing system capable of monitoring both blood flow velocity and the extent of edema/swelling in the lower leg was built, and preliminary tests were conducted. The results of this testing show that the system can accurately detect small changes in leg volume, but is not sensitive enough to measure blood flow velocity. New techniques for measuring blood flow velocity are currently being sought. Upon successful implementation of these technologies, a larger scale study will be conducted in order to generate a robust data set from which a control system can be derived.

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Ultrasonography of the femoral vessels in the groin: implications for vascular access

Cited by 64 publications

References 18 publications

Relation of Morbid Obesity and Female Gender to Risk of Procedural Complications in Patients Undergoing Atrial Fibrillation Ablation

Relation of Morbid Obesity and Female Gender to Risk of Procedural Complications in Patients Undergoing Atrial Fibrillation Ablation

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

A dynamic compression system for improving ulcer healing: Design of a sensing garment

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