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Femoral artery catheterization and vessel tortuosity
Insights
Vessel tortuosity can complicate arteriography. This study found no significant difference in tortuosity between the right and left sides, indicating no preferred side for catheterization. Significant tortuosity is often unilateral.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Medical Imaging
Background:
- Selective and superselective arteriography are crucial for diagnosing and treating vascular conditions.
- Vessel tortuosity, or abnormal curvature, can present challenges during arterial catheterization.
- Femoral arteriography is a common diagnostic procedure to visualize the aorta and its branches.
Purpose of the Study:
- To compare the degree of vessel tortuosity between the right and left femoral arteries.
- To determine the prevalence of significant tortuosity and assess its bilaterality.
- To inform procedural strategies for arteriography by understanding tortuosity patterns.
Main Methods:
- Retrospective analysis of 101 patients undergoing femoral arteriography.
- Quantitative assessment of vessel tortuosity on both right and left sides.
- Statistical comparison of tortuosity measurements between sides and identification of unilateral findings.
Main Results:
- No statistically significant difference in tortuosity was observed between the right and left femoral arteries.
- 14 patients (13.9%) and 21 patients (20.8%) exhibited tortuosity greater than 1 standard deviation above the mean on the right and left sides, respectively.
- Of the 29 patients with significant tortuosity, 23 (79.3%) had unilateral findings.
Conclusions:
- There is no anatomical advantage to initiating femoral arteriography preferentially on the right or left side due to tortuosity.
- Given that significant tortuosity is predominantly unilateral, clinicians should anticipate potential challenges and be prepared to proceed to the contralateral side efficiently.
- Understanding the unilateral nature of tortuosity can optimize procedural workflow and reduce delays in catheterization.
Abstract:
In the era of selective and superselective arteriography, vessel tortuosity, even in the presence of good pulses, can impede catheterization of the aorta and its branches. We assessed 101 patients who had femoral arteriography to determine whether there was a significant difference in tortuosity between the right and left sides and to define the degree to which significant tortuosity was bilateral. Fourteen and 21 patients had tortuosity greater than 1 standard deviation above the mean of the population on the right and left sides, respectively. This difference was not statistically significant. Twenty-three of the 29 patients with tortuosity greater than 1 standard deviation above the mean had this finding unilaterally. There is no advantage to preferentially beginning catheterization on a particular side. Furthermore, since 80% of significant tortuosity is unilateral, the contralateral femoral artery should be approached with only minimal delay when tortuosity that impedes catheterization is encountered.