title: Antegrade superficial femoral artery versus common femoral artery punctures for infrainguinal occlusive disease.
abstract: OBJECTIVE
  To compare the outcomes of planned superficial femoral artery (SFA) and common femoral artery (CFA) antegrade punctures in patients undergoing endovascular interventions for infrainguinal occlusive arterial disease in a single center.
  
  
  METHODS
  Between August 2010 and July 2011, consecutive patients who underwent antegrade puncture of CFA or SFA for infrainguinal occlusive disease were studied. Data including sheath size, rate of closure device usage, and complications relating to the arterial puncture were classified according to Society of Interventional Radiology (SIR) classification and analyzed retrospectively.
  
  
  RESULTS
  There were 199 antegrade arterial punctures, of which 28 (14%) were planned SFA punctures, performed in 184 patients. All patients had ultrasound-guided puncture. The sheath size ranged from 4 F to 8 F. In 2 of 28 (7%) SFA punctures, a closure device was deployed compared with 43 of 171 (25%) CFA punctures. Six bleeding complications were noted in the CFA puncture group (6 of 171 [3.5%]), of which 2 required urgent operations (repair of a pseudoaneurysm and evacuation of retroperitoneal hematoma). In comparison, only one minor groin hematoma was noted in the SFA puncture group; this did not require any further treatment. No thromboembolic complications were associated with SFA puncture.
  
  
  CONCLUSIONS
  Planned antegrade SFA puncture under ultrasound guidance can be performed safely in selected cases with no added morbidity. Interventionalists should have a low threshold for considering antegrade SFA puncture as a first-line access site, especially in patients with a hostile groin.
authors: Department of Vascular Surgery, Auckland City Hospital, Auckland, New Zealand. hyun_kweon@hotmail.com
authors: Michelle
authors: M
authors: Kweon
authors: Venu
authors: V
authors: Bhamidipaty
authors: Andrew
authors: A
authors: Holden
authors: Andrew A
authors: AA
authors: Hill
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D057510:Endovascular Procedures; D005263:Femoral Artery / Q000000981:diagnostic imaging; D006406:Hematoma / Q000209:etiology; D006470:Hemorrhage / Q000209:etiology / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D009520:New Zealand; D011677:Punctures; D012189:Retrospective Studies; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D062666:Vascular Access Devices