title: Fluoroscopic localization of the femoral head as a landmark for common femoral artery cannulation.
abstract: We sought to determine the reliability of frequently used landmarks for femoral arterial access in patients undergoing cardiac catheterization. The common femoral artery (CFA) is the most frequently used arterial access in cardiac catheterization. Arterial sheath placement into the CFA has been shown to decrease vascular complications. Some authors recommend locating the inferior border of the femoral head using fluoroscopy due to the relationship of the femoral head and the bifurcation of the CFA. We performed a descriptive study in a prospective design of 158 patients undergoing catheterization from the femoral approach. A femoral angiogram was performed, and the CFA bifurcation location was recorded in relation to the inguinal ligament, middle and inferior border of the femoral head, and the inguinal skin crease. The CFA bifurcation was distal to the inguinal ligament, middle femoral head, and inferior femoral head in most patients with mean distances (cm +/- SD) of 7.5 +/- 1.7, 2.9 +/- 1.5, and 0.8 +/- 1.2, respectively. The inguinal skin crease was below the bifurcation in 78% of patients (-1.8 +/- 1.6 cm). The CFA overlies the femoral head in 92% of cases. The femoral head has a consistent relationship to the CFA, and localization using fluoroscopy is a useful landmark.
authors.affiliation: Cardiology Service, Brooke Army Medical Center, Fort Sam Houston, Texas 78234, USA. paul.garrett@amedd.army.mil
authors.forename: Paul D
authors.initials: PD
authors.lastname: Garrett
authors.forename: Robert E
authors.initials: RE
authors.lastname: Eckart
authors.forename: Terry D
authors.initials: TD
authors.lastname: Bauch
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Thompson
authors.forename: Karl C
authors.initials: KC
authors.lastname: Stajduhar
mesh_terms: D002404:Catheterization; D005263:Femoral Artery / Q000000981:diagnostic imaging*; D005270:Femur Head / Q000098:blood supply* / Q000000981:diagnostic imaging; D005471:Fluoroscopy; D006119:Groin / Q000098:blood supply / Q000000981:diagnostic imaging; D006801:Humans; D007264:Inguinal Canal / Q000098:blood supply* / Q000000981:diagnostic imaging; D015203:Reproducibility of Results; D012867:Skin / Q000098:blood supply* / Q000000981:diagnostic imaging