Femoral bifurcation

Fig. 11 Left lateral oblique images of rabbits with experimental atherosclerotic lesions induced in the descending aorta imaged with In-111 labeled murine-human chimeric Z2D3 F(ab )2 (A and C) and In-111 labeled human IgG F(ab )2 (B and D). The in vivo gamma images are shown in A and B (k = kidney, U = urinary bladder activity, solid thin arrows = atherosclerotic lesions, and open larger arrow = spinal activity), and the ex vivo images of the excised aortas from the aortic arch to the femoral bifurcation are shown in C and D.

A two-component AneuRx bifurcated AAA stent graft with asymmetrical limbs and an ipsilateral extension introduced through the contralateral femoral artery. 

Abstract Identification of the anatomical anterior cruciate ligament (ACL) footprint is essential in femoral tuimel preparation. The lateral intercondylar ridge (LIR), which is termed the anterior border of the femoral ACL footprint, can be used as a landmark during surgery. The entire ACL footprint consists of the direct insertion of the ACL located behind the LIR and the attachment of fanlike extension fibers extended to the posterior cartilage margin. The lateral bifurcate ridge can be observed between the attached anteromedial (AM) and posterolateral (PL) bundles in 80 % of cases. 

Four patients developed tibial hypoplasia or aplasia associated with either femoral bifurcation or radial ray defect (Gollop-Wolfgang complex) after prenatal exposure to valproic acid [339", 340" ]. 

Anatomic Consideration The internal iliac arteries, the blood supply to the viscera of the true pelvis, are readily approached after femoral arterial access. The ipsilateral internal iliac artery is usually catheterized with a reverse curve catheter configuration and the contralateral internal iliac artery is usually accessed following passage over the aortic bifurcation with a forward seeking cobra catheter. On rare occasions because of atherosclerotic stenosis or occlusion of one femoral artery, two catheters (4-5 F) can be... 

There are three levels of occlusive disease in the lower limb arteries aortoiliac, femoropopliteal, and infrapopliteal disease. Disease confined to one level may be asymptomatic or it can present with intermittent claudication. The presence of two or three levels of disease are symptomatic, and patients usually present with severe claudication or rest pain. Three levels of disease are often seen in patients with skin damage and critical limb ischemia. Without an intervention most limbs with critical ischemia will be amputated within 1 year. In patients with diabetes mellitus the disease is usually confined in the infrapopliteal vessels. Such patients may develop critical limb ischemia with one level of disease because this is the most distal of the three. Usually, multiple stenoses and/or occlusions are found in at least two of the run-off arteries. Although it is known that atherosclerosis develops most often in bifurcations, in the lower extremities the most frequently involved site is the superficial femoral artery. Other common sites are the aortoiliac, iliac, femoral popliteal, and tibioperoneal trunk bifurcations. 

A femoral approach is preferred. If the side of the pelvic injury is known, the contralateral femoral artery should be used. This is because it is easier to catheterize 2nd- and 3rd-order vessels on the contralateral side, over the aortic bifurcation. If bilateral femoral artery access is impaired, an axillary or brachial approach can be used. An upper extremity... 

Fig. 6.5a,b. Selective angioplasty of the right femoral bifurcation a reveals an arteriovenous fistula (arrow) originating postosti-ally from the deep femoral artery, b After insertion of a covered stent (Viabahn 8x25 mm, W.L. Gore and Assoc., Flagstaff, AZ, USA), the arteriovenous fistula is completely excluded... 

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