scholarly journals Radiographic Relationships of the Femoral Head, Inguinal Ligament, and Common Femoral Artery Bifurcation for Optimal Vascular Access

2021 ◽  
Vol 74 (4) ◽  
pp. e328-e329
Author(s):  
Anand Brahmandam ◽  
Joshua Huttler ◽  
Kirthi Bellamkonda ◽  
Ocean Setia ◽  
Jonathan A. Cardella ◽  
...  
Keyword(s):  
Femoral Head ◽  
Vascular Access ◽  
Femoral Artery ◽  
Common Femoral Artery ◽  
Inguinal Ligament

scholarly journals Angiographic evaluation of a new technique for common femoral artery access: the inguinal ligament-guided

Heart ◽  
2011 ◽  
Vol 97 (Suppl 3) ◽  
pp. A160-A161
Author(s):  
N. Shaoping ◽  
L. Baiqiu ◽  
J. Changqi ◽  
Z. Yin ◽  
L. Qiang ◽  
...  
Keyword(s):  
Femoral Artery ◽  
Common Femoral Artery ◽  
Inguinal Ligament ◽  
New Technique ◽  
A New Technique

Stent fractures after common femoral artery bail-out stenting due to suture device failure in TAVR

VASA ◽  
2018 ◽  
Vol 47 (5) ◽  
pp. 393-401 ◽  
Author(s):  
Verena Veulemans ◽  
Shazia Afzal ◽  
Paul Ledwig ◽  
Christian Heiss ◽  
Lucas Busch ◽  
...  
Keyword(s):  
Stent Graft ◽  
Vascular Access ◽  
Femoral Artery ◽  
Common Femoral Artery ◽  
Covered Stent ◽  
Bleeding Control ◽  
Access Site ◽  
Stent Strut ◽  
Covered Stent Graft

Abstract. Background: Vascular access site-related complications are frequent in the context of transfemoral transcatheter aortic valve replacement (TAVR). The implantation of a covered stent graft is an effective treatment option for bleeding control. However, the external iliac and common femoral arteries are exposed to flexion of the hip joint. Therefore, stent compression and stent/strut fractures may occur, facilitating stent occlusion. Patients and methods: In all 389 patients who received transfemoral TAVR from 2013–2015 at the Düsseldorf Heart Centre, we monitored the management of vascular access site-related complications. Our analyses focused on immediate technical success and bleeding control, primary patency, and the occurrence of stent/strut fractures after six to 12 months of follow-up. Results: Vascular access site-related complications occurred in 13 % (n = 51), whereof in 10 patients, the bleeding was successfully managed by prolonged compression. In 40 out of 51 patients, a covered stent graft was implanted in the common femoral artery, leading to 100 % immediate bleeding control. After a mean follow-up of 334 ± 188 days, 28 stents out of 29 patients with completed follow-up (excluding e. g. death) were without flow-limiting stenosis (primary patency 97 %) or relevant stent compression (diameter pre/post 8.6/8.1 mm, p = 0.048, late lumen loss 1.1 ± 0.2 mm, mean flow velocity 92 ± 34 cm/s). In four asymptomatic patients, stent/strut fractures were detected (14 %) without flow-limiting stenosis. Conclusions: The implantation of a covered stent graft is highly effective and safe to control vascular access site-related complications after TAVR. Stent/strut fractures in the flexible segment of the common femoral artery may occur, as consequently verified by X-ray visualization, but show no impairment on flow or clinical parameters after six to 12 months.

Angiographic evaluation of a new technique for common femoral artery access: The inguinal ligament-guided approach

2013 ◽  
Vol 168 (2) ◽  
pp. 1542-1544 ◽  
Author(s):  
Shao-Ping Nie ◽  
Edmundo Patricio Lopes Lao ◽  
Xiao Wang ◽  
Xin-Min Liu ◽  
Yan Qiao ◽  
...  
Keyword(s):  
Femoral Artery ◽  
Common Femoral Artery ◽  
Inguinal Ligament ◽  
New Technique ◽  
A New Technique

Femoral Artery Exposure for Endovascular Aneurysm Repair through Oblique Incisions

1998 ◽  
Vol 5 (3) ◽  
pp. 259-260 ◽  
Author(s):  
Timothy A.M. Chuter ◽  
Linda M. Reilly ◽  
Ronald J. Stoney ◽  
Louis M. Messina
Keyword(s):  
Femoral Artery ◽  
Stab Wound ◽  
Endovascular Aneurysm Repair ◽  
External Iliac Artery ◽  
Common Femoral Artery ◽  
Inguinal Ligament ◽  
Wound Complications ◽  
Alternative Technique ◽  
Oblique Incision ◽  
Aneurysm Repair

Purpose: To offer an alternative technique for accessing the femoral artery prior to endovascular grafting. Technique: An oblique incision is made over the medial half of the inguinal ligament and continues to the femoral sheath, which is opened longitudinally. The distal external iliac artery and proximal common femoral artery are isolated. A tiny stab wound is made distal to the primary wound for femoral artery puncture and catheter access. Conclusions: Using an oblique incision at the level of the inguinal ligament optimizes exposure for endograft insertion and may minimize the frequency of serious wound complications.

scholarly journals Localization of the femoral artery bifurcation: hips don't lie – in at least 97% of cases

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
S Uehlein ◽  
S Smolka ◽  
M Arnold ◽  
M Marwan ◽  
S Achenbach
Keyword(s):  
Femoral Head ◽  
Femoral Artery ◽  
Hip Replacement ◽  
Age Groups ◽  
Vascular Complications ◽  
Common Femoral Artery ◽  
Femoral Access ◽  
Funding Sources ◽  
Transcatheter Aortic Valve ◽  
Upper Third

Abstract Background The most common vascular access for structural cardiac interventions such as transcatheter aortic valve implantation (TAVI) is the common femoral artery (CFA). Depending on the procedure CFA puncture has to be performed not only unilaterally, but also bilaterally. Since incorrect localization of femoral access can lead to severe vascular complications, specific knowledge about the exact position of the CFA bifuraction is helpful. Such information might be systematically obtained from pre-TAVI CT scans. Methods We performed a retroperspective analysis of consecutive contrast-enhanced pre-TAVI CT angiography data sets (n=1000) to determine the CFA bifurcation localization relative to the femoral head and the correlation to contralateral CFA bifurcation location. Results The site of the CFA bifurcation was in 67.2% below the femoral head (−−), in 24.3% within the lower third of the femoral head (−), in 7.4% in the mid (0) and in 1.2% within the upper third (+) of the femoral head. Bifurcations above (++) the femoral head were not detected. CFA bifurcations below the femoral head showed the highest prevalence within men and women in all age groups (50–59, 60–69, 70–79, 80–89, 90–99 years). Bilateral agreement of CFA bifurcations was observed in only 69.3% and was independent of one-sided hip replacement (agreement 72.7%) or two-sided hip replacement (agreement 78.7%). A congruent contralateral left CFA bifurcation below the femoral head could be predicted in 80.6%, whereas CFA bifurcations within the lower and upper margins of the femoral head were congruent in only 65.7% (of these, 49.2% for the lower third, 29.7% for the mid and 36.4% for the upper third). Conclusion In conclusion, punctures within the upper third of the femoral head will provide an ideal puncture site in at least 97% of cases, independent of age, sex, or previous hip replacement. FUNDunding Acknowledgement Type of funding sources: None.

Femoral Vascular Access – Approaches and Available Devices

2012 ◽  
Vol 7 (2) ◽  
pp. 108
Author(s):  
Benjamin H Holland ◽  
Robert J Applegate ◽  
◽  
Keyword(s):  
Vascular Access ◽  
Femoral Artery ◽  
Healthcare Costs ◽  
Common Femoral Artery ◽  
Delivery Systems ◽  
Manual Compression ◽  
Femoral Access ◽  
Cardiac Procedures ◽  
The Common

Femoral access remains a vital route for many cardiac and non-cardiac procedures, including those involving the use of large delivery systems. In the common femoral artery access is extremely important to minimise complications and optimise use of closure devices. Dissatisfaction with haemostasis achieved by manual compression stimulated development of VCDs that provide quick and effective haemostasis after sheath removal. Despite shortening time to haemostasis and ambulation, a debate still rages regarding their overall contribution to reducing complications and healthcare costs.

Safety and efficacy of combined micropuncture and shallow angle femoral artery access for neurovascular angiography

2015 ◽  
Vol 18 (3) ◽  
pp. 264-268
Author(s):  
Austin C. Bourgeois ◽  
Chris T. Kolze ◽  
Marcelo S. Guimaraes ◽  
Alexander S. Pasciak ◽  
Andrew S. Ferrell ◽  
...  
Keyword(s):  
Vascular Access ◽  
Femoral Artery ◽  
Demographic Data ◽  
Common Femoral Artery ◽  
Bleeding Risk ◽  
Bleeding Complications ◽  
Arterial Access ◽  
Specific Protocol ◽  
Vascular Sheath ◽  
Manual Pressure

Introduction The AXERA 2 low-angle vascular access device utilizes a dual arteriotomy mechanism in which the standard access tract is compressed by a vascular sheath inserted over the second, low-angle tract. It is unknown whether this device could be effectively used with 21-gauge micropuncture access, as the micropuncture introducer makes a larger arteriotomy than the 19-gauge needle provided with the AXERA 2 system. Materials and Methods A retrospective review was performed on 189 patients who underwent common femoral artery access for diagnostic cerebrovascular angiography using either combined micropuncture and AXERA 2 access or standard access with manual pressure hemostasis. Demographic and procedural data were reviewed along with complications related to vascular access and times to bed elevation, ambulation and discharge. Results Combined micropuncture and AXERA 2 access was performed on 110 patients and 79 patients had standard access. The AXERA device was successfully used in 91.8% of the cases. Demographic data, anticoagulant use and sheath sizes were similar between both subsets. Use of the AXERA 2 was associated with two bleeding complications (1.8%) compared with 10 (12.7%) with manual pressure hemostasis alone. Institution-specific protocol allowed shorter mean manual compression time, as well as shorter times to ambulation and discharge with the AXERA 2. Conclusions Use of the AXERA 2 device with micropuncture access did not infer increased bleeding risk than standard arterial access in this patient series. The considerable incidence of device use failures suggests a learning curve associated with its use.

scholarly journals Common Femoral Artery Access: 2-Dimensional Operative Video

2020 ◽  
Vol 19 (6) ◽  
pp. E594-E594
Author(s):  
Maureen A Darwal ◽  
Mandy J Binning ◽  
Mark Bain ◽  
Bernard Bendock ◽  
Alan S Boulos ◽  
...  
Keyword(s):  
Vascular Access ◽  
Femoral Artery ◽  
Cerebral Angiography ◽  
Limb Ischemia ◽  
Common Femoral Artery ◽  
Retroperitoneal Hematoma ◽  
Anatomic Landmarks ◽  
The Common ◽  
Groin Hematoma ◽  
Safe Access

Abstract Vascular access for cerebral angiography has traditionally been performed via the common femoral artery. It is crucial to obtain safe access to prevent complications that could lead to limb ischemia, groin hematoma, or retroperitoneal hematoma. This is especially true in neurointervention as many patients are anticoagulated or have received intravenous thrombolytics prior to their intervention. Special attention to anatomic landmarks, both grossly and radiographically, can help to assure safe access. The patient consented for this procedure. This video details rapid but safe femoral artery access in a patient undergoing emergent thrombectomy.

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