title: Defining the common femoral artery: Insights from the femoral arterial access with ultrasound trial.
abstract: OBJECTIVE
  We sought to establish the typical location of the common femoral artery (CFA) bifurcation, the origin and most inferior reflection of the inferior epigastric artery (IEA) relative to the femoral head (FH) and whether patient demographics predicted anatomical variations.
  
  
  BACKGROUND
  In the absence of ultrasound guidance or prior imaging, the precise location of the CFA bifurcation and IEA can only be determined following access site angiography. Fluoroscopic landmarks are commonly used to estimate the location of the CFA bifurcation, but the position of the IEA is less well characterized.
  
  
  METHODS
  Prospectively collected data on 989 patients with femoral angiography in the FAUST trial were analyzed. The level of CFA bifurcation and the origin and most inferior reflection of the IEA were classified by angiography. Logistic regression was used to explore whether baseline demographics were associated with anatomic variations.
  
  
  RESULTS
  The CFA bifurcation occurs below the middle 1/3rdof the femoral head in 95% of patients, and no patient factors are predictive of a high bifurcation. The IEA origin has a more variable anatomically pattern, with high BSA, male gender, and white race associated with a low IEA origin.
  
  
  CONCLUSIONS
  Operators should attempt to access the CFA at the level of the middle 1/3rdof the FH to maximize the chance of CFA cannulation. However, this location carries an 11% risk of being at or above the IEA origin. Baseline demographics were of limited utility for predicting anatomic variants of the CFA bifurcation and the course of the IEA. © 2016 Wiley Periodicals, Inc.
authors: Department of Medicine, Veterans Affairs Long Beach Health Care System, Long Beach, California.|Department of Medicine, University of Califonia, Irvine Medical Center, Orange, California.
authors: Arnold H
authors: AH
authors: Seto
authors: Department of Medicine, University of California, San Francisco Medical Center, San Francisco, California.
authors: Jeffrey
authors: J
authors: Tyler
authors: Department of Medicine, University of California, Los Angeles Medical Center, Los Angeles, California.
authors: William M
authors: WM
authors: Suh
authors: Central Coast Comprehensive Cardiovascular Imaging, Santa Maria, California.
authors: Alexander T
authors: AT
authors: Harrison
authors: Cardiothoracic Department, St Jude Medical Center, Fullerton, California.
authors: Jesus A
authors: JA
authors: Vera
authors: Oklahoma Heart Hospital, Midwest City, Oklahoma.
authors: Soni J
authors: SJ
authors: Zacharias
authors: Department of Cardiology, INTEGRIS Heart Hospital, Oklahoma City, Oklahoma.
authors: Timothy S
authors: TS
authors: Daly
authors: Department of Cardiology, INTEGRIS Heart Hospital, Oklahoma City, Oklahoma.
authors: Jeffrey M
authors: JM
authors: Sparling
authors: Department of Medicine, University of Califonia, Irvine Medical Center, Orange, California.
authors: Pranav M
authors: PM
authors: Patel
authors: Department of Medicine, Veterans Affairs Long Beach Health Care System, Long Beach, California.|Department of Medicine, University of Califonia, Irvine Medical Center, Orange, California.
authors: Morton J
authors: MJ
authors: Kern
authors: Department of Medicine, Cardiovascular section, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
authors: Mazen
authors: M
authors: Abu-Fadel
mesh_terms: D059925:Anatomic Landmarks; D000792:Angiography; D001830:Body Surface Area; D002406:Catheterization, Peripheral; D016009:Chi-Square Distribution; D019074:Epigastric Arteries / Q000000981:diagnostic imaging; D005260:Female; D005263:Femoral Artery / Q000002:abnormalities / Q000000981:diagnostic imaging*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015588:Observer Variation; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011677:Punctures; D015203:Reproducibility of Results; D012737:Sex Factors; D018084:Ultrasonography, Interventional; D014481:United States; D054079:Vascular Malformations / Q000000981:diagnostic imaging*; D044465:White People
keywords: anatomic variants; angiography; catheterization; vascular access; vascular complications