Comparison of ultrasound guidance with the traditional palpation and fluoroscopy method for the common femoral artery puncture

Gedikoglu, Murat; Oğuzkurt, Levent; Gür, Serkan; Andıç, Çağatay; Sarıtürk, Çağla; Özkan, Uğur

doi:10.1002/ccd.24955

Cited by 70 publications

(46 citation statements)

References 27 publications

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“…In a more recent trial, interventional radiologists from two institutions randomized 208 patients undergoing retrograde puncture of the common femoral artery to either ultrasound-guided or palpation-guided puncture 33 . As with the FAUST trial, higher first pass success rates, fewer total number of attempts required for access, and reduced times to sheath insertion were seen in the group in whom ultrasound-guided puncture was used.…”

Section: Discussionmentioning

confidence: 99%

Routine use of ultrasound-guided access reduces access site-related complications after lower extremity percutaneous revascularization

Fokkema

Curran

et al. 2015

Journal of Vascular Surgery

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Objectives We sought to elucidate the risks for access site-related complications (ASC) following percutaneous lower extremity revascularization and to evaluate benefit of routine ultrasound-guided access (RUS) in decreasing ASC. Methods We reviewed all consecutive percutaneous revascularizations (PTA or stent) performed for lower extremity atherosclerosis at our institution from 2002–2012. RUS began September 2007. Primary outcome was any ASC (bleeding, groin or retroperitoneal [RP] hematoma, vessel rupture, or thrombosis). Multivariable logistic regression was used to determine predictors of ASC. Results A total of 1,371 punctures were performed on 877 patients (43% women, median age 69 [IQR 60–78] yrs for claudication (29%), critical limb ischemia (59%), or bypass graft stenosis (12%) using 4–8Fr sheaths. There were 72 ASCs (5%): 52 instances of bleeding or groin hematoma, 9 pseudoaneurysms, 8 retroperitoneal hematomas, 2 artery lacerations, and 1 thrombosis. ASC were less frequent when RUS was used (4% vs. 7%, P=.02). Multivariable predictors of ASC were age >75 years (OR 2.0, 95% CI 1.1–3.7, P=.03), CHF (OR 1.9, 95% CI 1.1–1.3, P=.02), preoperative warfarin use (OR 2.0, 95% CI 1.1–3.5, P=.02), & RUS (OR 0.4, 95% CI 0.2–0.7, P<.01). Vascular closure devices (VCDs) were not associated with lower rates of ASCs (OR 1.1, 95% CI 0.2–0.7, P<.01). RUS lowered ASCs in those >75 years (5% vs. 12%, P<.01) but not those on warfarin preoperatively (10% vs. 13%, P=.47). RUS did not decrease VCD failure (6% vs. 4%, P=.79). Conclusions We were able to decrease the rate of ASCs during lower extremity revascularization with the implementation of RUS. VCDs did not impact ASCs. Particular care should be taken on patients >75 years old, those with CHF, and those on warfarin.

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Section: Discussionmentioning

confidence: 99%

Routine use of ultrasound-guided access reduces access site-related complications after lower extremity percutaneous revascularization

Fokkema

Curran

et al. 2015

Journal of Vascular Surgery

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“…A multicentre RCT found RTUS-guidance for retrograde femoral artery access to be more successful than fluoroscopic guidance, but only in patients with a high bifurcation of the common femoral artery. In all patients RTUS-guidance improved first-pass access rate and speed of the procedure and resulted in a lower rate of venous puncture [44,55,56]. If traditional common femoral artery access is hampered by morbid obesity or by a "hostile groin", RTUS-guided superficial artery access seems to be technically easier, safer and faster compared with RTUS-guided common femoral artery access [55].…”

Section: Technique and Resultsmentioning

confidence: 99%

US-guided peripheral vascular interventions, comments on the EFSUMB guidelines

Dietrich

Horn²,

Morf

et al. 2016

Med Ultrason

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Peripheral venous as well as arterial punctures have traditionally been performed on the basis of designated anatomical landmarks. However, due to patients' individual anatomy and vessel pathology and depending on individual operators' skill, this landmark approach is associated with a significant failure rate and complication risk. This review comments on the evidence-based recommendations on ultrasound (US)-guided vascular access which have been published recently within the framework of Guidelines on Interventional Ultrasound (INVUS) of the European Federation of Societies for US in Medicine and Biology (EFSUMB) from a clinical practice point of view. Part 1 of the review had its focus on general aspects of USguidance and on central venous access, whereas part 2 refers to peripheral vascular access.

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“…We use Visipaque 320 [2]. Contrast-induced nephropathy (CIN) is an infrequent adverse reaction to iodinated contrast agents [3]. In endovascular procedures, particular complex procedures are associated with CIN and larger doses of contrast are considered a risk factor.…”

Section: Angiography and Endovascular Therapy For Peripheral Artery Dmentioning

confidence: 99%

Basics of Angiography for Peripheral Artery Disease

Yokoi¹

2017

Angiography and Endovascular Therapy for Peripheral Artery Disease

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Angiography has been historically used to image the peripheral artery system and still remains the gold standard for diagnostic and endovascular treatment. There is no standardized method for lower limb artery angiography. In this chapter, the basic standard technique for angiography of peripheral artery is described from aortoiliac, femoropopliteal and below the knee arteries. To obtain a good image, adequate contrast dose and image size must be determined with the appropriate catheter. For puncture, echo-guided approach is becoming popular; each lab needs to have echo machine to minimize the vascular complication. In cases of renal dysfunction, CO 2 angiography is suited. However, care must be taken to deliver gas into arterial system and to know the merit and demerit of CO 2 angiography.

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Comparison of ultrasound guidance with the traditional palpation and fluoroscopy method for the common femoral artery puncture

Abstract: Ultrasound guidance improves secondary outcomes of the common femoral artery puncture when compared to palpation-guided puncture. Technical success and complication rates seem lower in the presence of ultrasound guidance but larger study populations are needed to verify the result.

Cited by 70 publications

References 27 publications

Routine use of ultrasound-guided access reduces access site-related complications after lower extremity percutaneous revascularization

Routine use of ultrasound-guided access reduces access site-related complications after lower extremity percutaneous revascularization

US-guided peripheral vascular interventions, comments on the EFSUMB guidelines

Basics of Angiography for Peripheral Artery Disease

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