Related Experiment Videos
Optimizing safe femoral access during cardiac catheterization
1Department of Internal Medicine, Cardiology Division, State University of New York at Stony Brook, Stony Brook, New York 11794, USA.
Insights
This study analyzed femoral artery anatomy using angiography, revealing average diameters and bifurcation levels. Findings indicate a high success rate for optimal arterial access via a standard dermotomy technique.
Area of Science:
- Vascular anatomy
- Medical imaging
- Interventional cardiology
Background:
- Femoral arterial access is crucial for endovascular procedures.
- Variability in femoral artery anatomy can impact procedural success and safety.
- Standardized anatomical landmarks are essential for consistent access.
Purpose of the Study:
- To characterize the natural variability of femoral arterial anatomy.
- To determine the optimal location for femoral arterial access.
- To assess the efficacy of a standard dermotomy for achieving arterial access.
Main Methods:
- Analysis of 60 consecutive peripheral angiograms.
- Measurement of common femoral artery, superficial femoral artery, and deep femoral artery diameters.
- Calculation of the bifurcation level of the common femoral artery.
- Statistical analysis of access success using a standard dermotomy placement.
Main Results:
- Average common femoral artery diameter: 6.6 mm (range 3.9-8.9 mm).
- Average superficial femoral artery diameter: 5.2 mm (range 2.5-9.6 mm).
- Average deep femoral artery diameter: 4.9 mm (range 2.7-7.6 mm).
- Common femoral artery bifurcation averaged 5.5 mm below the femoral head (76% of cases).
- A standard dermotomy achieved favorable access in 97% of cases.
Conclusions:
- Significant natural variability exists in femoral artery anatomy.
- A standard dermotomy, placed midway between the superior anterior iliac spine and pubic symphysis and 3 cm below, provides reliable femoral arterial access.
- Understanding anatomical variations improves procedural planning and success rates.
Abstract:
This article describes the natural variability of femoral arterial anatomy as seen by angiography in a standard position. An analysis of 60 consecutive peripheral angiograms revealed data on average vessel diameter, variability in that diameter and the level of bifurcation of the common femoral artery into its two main branches. The statistical likelihood of optimal femoral arterial access through a standard dermotomy placed midway between, and 3 cm below, the imaginary line extending from the superior anterior iliac spine to the pubic symphysis was calculated. Our research disclosed average vessel diameters of 6.6 mm (3.9-8.9 mm), 5.2 mm (2.5-9.6 mm), and 4.9 mm (2.7-7.6 mm) for the common femoral artery, superficial femoral artery and deep femoral artery, respectively. The bifurcation of the common femoral artery into its branches averaged 5.5 mm below the inferior margin of the femoral head in most cases (76% of the time). In our laboratory, the average distance from the inferior border of the femoral head to our actual arteriotomy was 14.0 mm. Using our standard dermotomy, we achieved this favorable access position in 97% of cases.