Common Femoral Artery Access: 2-Dimensional Operative Video

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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Femoral Balloon-Oriented Puncture for True Lumen Reentry in the Common Femoral Artery After Subintimal Retrograde Recanalization of Superficial Femoral Artery Ostial Occlusion: The FORLEE Technique

Journal of Endovascular Therapy ◽

10.1177/1526602819849722 ◽

2019 ◽

Vol 26 (4) ◽

pp. 490-495 ◽

Cited By ~ 1

Author(s):

Gabriele Testi ◽

Tanja Ceccacci ◽

Mauro Cevolani ◽

Francesco Giacchi ◽

Fabio Tarantino ◽

...

Keyword(s):

Femoral Artery ◽

Superficial Femoral Artery ◽

Balloon Catheter ◽

Duplex Ultrasound ◽

Cost Effective ◽

Limb Ischemia ◽

Common Femoral Artery ◽

Anterior Tibial Artery ◽

True Lumen ◽

The Common

Purpose: To report a new technique to reenter the common femoral artery (CFA) true lumen after retrograde recanalization of a superficial femoral artery (SFA) with flush ostial occlusion. Technique: The technique is demonstrated in a 76-year-old woman with critical limb ischemia previously submitted to several surgical revascularizations. A duplex ultrasound showed flush ostial occlusion of the SFA and patency of the anterior tibial artery at the ankle as the sole outflow vessel. After unsuccessful antegrade attempts to recanalize the SFA, a retrograde guidewire was advanced subintimally up to the CFA, without gaining reentry. A balloon catheter was inflated in the subintimal plane across the SFA ostial occlusion. Antegrade access to the distal CFA was achieved with a 20-G needle, which was used to puncture the balloon. A guidewire was advanced into the balloon and pushed forward while the collapsed balloon was pulled back to the mid SFA. The antegrade guidewire was externalized through a retrograde catheter, which was pushed in the CFA true lumen. A retrograde guidewire was advanced and externalized through the femoral sheath, establishing a flossing wire. The procedure was completed in antegrade fashion. Conclusion: The FORLEE technique is a cost-effective option to gain the CFA true lumen after subintimal retrograde recanalization of an ostial SFA occlusion.

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Endovascular Treatment of the Common Femoral Artery for Limb Ischemia

Vascular and Endovascular Surgery ◽

10.1177/1538574413500723 ◽

2013 ◽

Vol 47 (8) ◽

pp. 639-644 ◽

Cited By ~ 16

Author(s):

Robert S. M. Davies ◽

William Adair ◽

Amman Bolia ◽

Guy Fishwick ◽

Robert D. Sayers ◽

...

Keyword(s):

Endovascular Treatment ◽

Femoral Artery ◽

Limb Ischemia ◽

Common Femoral Artery ◽

The Common

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Ruptured Common Femoral Artery Aneurysm or Abdominal Aortic Aneurysm?

Case Reports in Surgery ◽

10.1155/2013/306987 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4

Author(s):

Tetsuya Niino ◽

Satoshi Unosawa ◽

Haruka Kimura

Keyword(s):

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Femoral Artery ◽

Groin Pain ◽

Artery Aneurysm ◽

Common Femoral Artery ◽

Retroperitoneal Hematoma ◽

Left Groin ◽

Abdominal Aortic ◽

The Common

We encountered a patient with a large retroperitoneal hematoma due to rupture of a common femoral artery aneurysm. A 77-year-old man was transferred to our hospital with left groin pain and shock. Computed tomography demonstrated a large retroperitoneal hematoma involving the left iliofemoral segment with extravasation of contrast into the left groin from a ruptured left common femoral artery aneurysm. The patient also had an abdominal aortic aneurysm. Reconstruction of the common femoral artery with a graft was performed successfully. The patient had an uneventful postoperative course and subsequently underwent Y-graft replacement of the abdominal aortic aneurysm.

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Feasibility of Vascular Access Closure in Arteries Other Than the Common Femoral Artery Using the ExoSeal Vascular Closure Device

CardioVascular and Interventional Radiology ◽

10.1007/s00270-014-0853-x ◽

2014 ◽

Vol 37 (5) ◽

pp. 1352-1357 ◽

Cited By ~ 9

Author(s):

Claus Christian Pieper ◽

Kai E. Wilhelm ◽

Hans Heinz Schild ◽

Carsten Meyer

Keyword(s):

Vascular Access ◽

Femoral Artery ◽

Common Femoral Artery ◽

Closure Device ◽

Vascular Closure Device ◽

The Common

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Femoral Vascular Access – Approaches and Available Devices

Interventional Cardiology Review ◽

10.15420/icr.2012.7.2.108 ◽

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.

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Femoral Vascular Closure Device: The Surgical View

Vascular ◽

10.2310/6670.2008.00046 ◽

2008 ◽

Vol 16 (5) ◽

pp. 295-296

Author(s):

Alfried Germing ◽

Michael Lindstaedt ◽

Delawer Reber

Keyword(s):

Case Report ◽

Coronary Angiography ◽

Vascular Access ◽

Femoral Artery ◽

Common Femoral Artery ◽

Percutaneous Closure ◽

Closure Device ◽

Vascular Closure Device ◽

The Common ◽

Diagnostic Coronary Angiography

This case report describes the surgical findings of a percutaneous closure device, which was used after diagnostic coronary angiography. The features of the device are described. Surgeons should be familiar with the existence of these devices to avoid complications during vascular access procedures at the level of the common femoral artery.

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Kissing Stents in the Common Femoral Artery Bifurcation for Critical Limb Ischemia: Technical Description and Report of Three Cases

Vascular ◽

10.2310/6670.2007.00037 ◽

2007 ◽

Vol 15 (4) ◽

pp. 211-214 ◽

Cited By ~ 12

Author(s):

Sven Ross Mathisen ◽

Michael Åkesson ◽

Mats Lindh ◽

Krassi Ivancev ◽

Timothy A. Resch

Keyword(s):

Femoral Artery ◽

Critical Limb Ischemia ◽

Limb Ischemia ◽

Common Femoral Artery ◽

Short Term ◽

Number Of Patients ◽

The Common ◽

Kissing Stent ◽

Patch Plasty

The purpose of this article is to describe three cases of kissing stent placement in the common femoral artery bifurcation in patients unsuitable for open endarterectomy and patch plasty. In three patients with critical limb ischemia, caused by primary atherosclerotic disease or dissection-related injury when performing a lower extremity intervention, a technique of kissing stents was used to treat the flow-obstructing lesion in the common femoral artery bifurcation. Technical success was uniform, and during follow-up (4.5–8 months), all patients showed improved symptoms, wound healing, and duplex ultrasonography–verified patency of the stents. Kissing stents in the common femoral artery bifurcation are a feasible treatment option in patients with limited mobililty or contraindications to open repair. The short-term results seem promising, but longer follow-up and an increased number of patients will be needed to assess the durability of the reconstruction.

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