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Complications of Femoral Artery Sheath Insertion in Non-Fluoroscopic Resuscitation: A Single-Center Observational
Takahiro Michishita1,2, Naoya Suzuki1,2, Takeru Abe3
1Department of Emergency Medicine Yokosuka Kyosai Hospital Yokosuka Japan.
Aim:
Femoral artery sheath insertion is a common resuscitation procedure; however, most research on complications focuses on cardiovascular medicine. No studies have examined sheath insertion complications in emergency or intensive care settings where fluoroscopy is unavailable. This study investigated complications associated with femoral artery sheath insertion in non-fluoroscopic resuscitation.
Methods:
This retrospective, single-center observational study included patients who underwent femoral artery sheath insertion for resuscitation under non-fluoroscopic conditions between April 2014 and August 2024 and subsequently underwent computed tomography. Patients were categorized into the non-complication and complication groups. Vascular and skin insertion positions were measured using computed tomography, and patient backgrounds were compared between groups.
Results:
The study included 151 patients in the non-complication group and 16 in the complication group, yielding a complication rate of 9.6%. A significant difference was observed in sheath insertion position (p < 0.001). The proportion of sheath insertions at the level of the femoral head was higher in the non-complication group, whereas insertions below the femoral head were more frequent in the complication group.
Conclusion:
Femoral artery sheath insertion without fluoroscopy during resuscitation was associated with a 9.6% complication rate, with the complication group having a higher rate of vascular puncture below the femoral head than the non-complication group.
