Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Assessment of the Optimal Site of Femoral Artery Puncture and Angiographic Anatomical Study of the Common Femoral Artery

  • Ahn, Ho-Young (Department of Neurosurgery, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Lee, Hyung-Jin (Department of Neurosurgery, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Lee, Hong-Jae (Department of Neurosurgery, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Yang, Ji-Ho (Department of Neurosurgery, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Yi, Jin-Seok (Department of Neurosurgery, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Lee, Il-Woo (Department of Neurosurgery, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea)
  • Received : 2014.03.21
  • Accepted : 2014.08.16
  • Published : 2014.08.28
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Abstract

Objective : The purpose of this study was to evaluate demographic and clinical factors affecting the common femoral artery diameter and length, and anatomical relationship between the femoral head and the common femoral artery during angiography. Methods : We retrospectively reviewed 109 femoral angiograms. We collected the clinical data of the patients and estimated the common femoral artery diameter and length. We divided the areas in the angiogram from cephalic to caudal direction (zone 0 to 5). The lowest levels of the inferior epigastric artery loop and points of the common femoral artery bifurcation were checked. Results : The luminal diameter of the common femoral artery was $6.19{\pm}1.20mm$. Height, weight, body surface area, as well as common femoral artery diameter were significantly greater in men than in women (p<0.005). The length of the common femoral artery was $27.59{\pm}8.87mm$. Height, weight and body surface area showed strong positive relationships with common femoral artery diameter. All of the inferior epigastric artery loops were located above the center of the femoral head. The point of common femoral artery bifurcation was above the center of the femoral head in 4.59% of femoral angiograms. Conclusions : Males and patients with a high body surface area have a larger common femoral artery diameter. The cumulative probability of optimal targeting between the lowest margin of the inferior epigastric artery loop and the common femoral artery bifurcation is the highest in zone 3 puncture.

Keywords

References

  1. Abu-Fadel MS, Sparling JM, Zacharias SJ, Aston CE, Saucedo JF, Schechter E, et al. : Fluoroscopy vs. traditional guided femoral arterial access and the use of closure devices : a randomized controlled trial. Catheter Cardiovasc Interv 74 : 533-539, 2009 https://doi.org/10.1002/ccd.22174
  2. Chandrasekar B, Doucet S, Bilodeau L, Crepeau J, deGuise P, Gregoire J, et al. : Complications of cardiac catheterization in the current era : a single-center experience. Catheter Cardiovasc Interv 52 : 289-295, 2001 https://doi.org/10.1002/ccd.1067
  3. Chiam PT, Koh AS, Ewe SH, Sin YK, Chao VT, Ng CK, et al. : Iliofemoral anatomy among Asians : implications for transcatheter aortic valve implantation. Int J Cardiol 167 : 1373-1379, 2013 https://doi.org/10.1016/j.ijcard.2012.04.001
  4. Dudeck O, Teichgraeber U, Podrabsky P, Lopez Haenninen E, Soerensen R, Ricke J : A randomized trial assessing the value of ultrasound-guided puncture of the femoral artery for interventional investigations. Int J Cardiovasc Imaging 20 : 363-368, 2004 https://doi.org/10.1023/B:CAIM.0000041949.59255.3f
  5. Ellis SG, Bhatt D, Kapadia S, Lee D, Yen M, Whitlow PL : Correlates and outcomes of retroperitoneal hemorrhage complicating percutaneous coronary intervention. Catheter Cardiovasc Interv 67 : 541-545, 2006 https://doi.org/10.1002/ccd.20671
  6. Farouque HM, Tremmel JA, Raissi Shabari F, Aggarwal M, Fearon WF, Ng MK, et al. : Risk factors for the development of retroperitoneal hematoma after percutaneous coronary intervention in the era of glycoprotein IIb/IIIa inhibitors and vascular closure devices. J Am Coll Cardiol 45 : 363-368, 2005 https://doi.org/10.1016/j.jacc.2004.10.042
  7. Fitts J, Ver Lee P, Hofmaster P, Malenka D; Northern New England Cardiovascular Study Group : Fluoroscopy-guided femoral artery puncture reduces the risk of PCI-related vascular complications. J Interv Cardiol 21 : 273-278, 2008 https://doi.org/10.1111/j.1540-8183.2008.00351.x
  8. Grier D, Hartnell G : Percutaneous femoral artery puncture : practice and anatomy. Br J Radiol 63 : 602-604, 1990 https://doi.org/10.1259/0007-1285-63-752-602
  9. Irani F, Kumar S, Colyer WR Jr : Common femoral artery access techniques : a review. J Cardiovasc Med (Hagerstown) 10 : 517-522, 2009 https://doi.org/10.2459/JCM.0b013e32832a1e00
  10. Johnson LW, Esente P, Giambartolomei A, Grant WD, Loin M, Reger MJ, et al. : Peripheral vascular complications of coronary angioplasty by the femoral and brachial techniques. Cathet Cardiovasc Diagn 31 : 165-172, 1994 https://doi.org/10.1002/ccd.1810310302
  11. Johnson LW, Krone R : Cardiac catheterization 1991 : a report of the Registry of the Society for Cardiac Angiography and Interventions (SCA&I). Cathet Cardiovasc Diagn 28 : 219-220, 1993 https://doi.org/10.1002/ccd.1810280305
  12. Kim D, Orron DE, Skillman JJ, Kent KC, Porter DH, Schlam BW, et al. : Role of superficial femoral artery puncture in the development of pseudoaneurysm and arteriovenous fistula complicating percutaneous transfemoral cardiac catheterization. Cathet Cardiovasc Diagn 25 : 91-97, 1992 https://doi.org/10.1002/ccd.1810250203
  13. Nasser TK, Mohler ER 3rd, Wilensky RL, Hathaway DR : Peripheral vascular complications following coronary interventional procedures. Clin Cardiol 18 : 609-614, 1995 https://doi.org/10.1002/clc.4960181105
  14. Pitta SR, Prasad A, Kumar G, Lennon R, Rihal CS, Holmes DR : Location of femoral artery access and correlation with vascular complications. Catheter Cardiovasc Interv 78 : 294-299, 2011 https://doi.org/10.1002/ccd.22827
  15. Sandgren T, Sonesson B, Ahlgren R, Lanne T : The diameter of the common femoral artery in healthy human : influence of sex, age, and body size. J Vasc Surg 29 : 503-510, 1999 https://doi.org/10.1016/S0741-5214(99)70279-X
  16. Schnyder G, Sawhney N, Whisenant B, Tsimikas S, Turi ZG : Common femoral artery anatomy is influenced by demographics and comorbidity : implications for cardiac and peripheral invasive studies. Catheter Cardiovasc Interv 53 : 289-295, 2001 https://doi.org/10.1002/ccd.1169
  17. Seldinger SI : Catheter replacement of the needle in percutaneous arteriography; a new technique. Acta radiol 39 : 368-376, 1953 https://doi.org/10.3109/00016925309136722
  18. Sherev DA, Shaw RE, Brent BN : Angiographic predictors of femoral access site complications : implication for planned percutaneous coronary intervention. Catheter Cardiovasc Interv 65 : 196-202, 2005 https://doi.org/10.1002/ccd.20354
  19. Yaganti V, Mejevoi N, Hasan O, Cohen M, Wasty N : Pitfalls associated with the use of current recommendations for fluoroscopy-guided common femoral artery access. Catheter Cardiovasc Interv 81 : 674-679, 2013 https://doi.org/10.1002/ccd.24335

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