title: Safety of early ambulation in patients undergoing ultrasound-guided femoral low angle arterial access technique (FLAT).
abstract: OBJECTIVE
  To evaluate the safety of early ambulation in patients undergoing transfemoral arterial interventions via ultrasound-guided femoral low angle arterial access technique (FLAT).
  
  
  METHODS
  A total of 58 patients undergoing 72 transfemoral arterial procedures that underwent an attempt at FLAT for femoral artery cannulation at our institution from November 2014 to July 2015 were retrospectively identified. Technical success was defined as obtaining less than a 35-degree angle of entry through the anterior wall of the common femoral artery. Patients for which a low angle was achieved were ambulated after 2hours after hemostasis was achieved with manual compression. All patients received out-patient clinic follow-up which included ultrasound examination of the femoral artery. Chart review provided demographic data, pertinent past medical history, procedural information (type of procedure, size of femoral access sheath, time to ambulation), complications related to arterial access and follow up.
  
  
  RESULTS
  Twelve patients were excluded from the study due to inability to analyze ultrasound images. A low angle was achieved in 37 patients (17 men, 20 women; mean age: 58.5 years±13.1 [SD]) undergoing 45 procedures who met inclusion criteria for the study, yielding technical success rate of 75%. There was a moderate positive correlation between the access angle and depth of the common femoral artery at the site of puncture (r=0.45; P<0.01). All patients were followed up within 2 weeks of the initial procedure in the outpatient clinic. No arterial access-related complications occurred.
  
  
  CONCLUSIONS
  Femoral artery cannulation using FLAT followed by manual compression and ambulation after 2 hours appears to be a safe approach.
authors.affiliation: Division of vascular and interventional radiology, department of radiology, Mount Sinai Beth Israel, first avenue at Sixteenth Street, 10010 New York, United States.
authors.forename: P A
authors.initials: PA
authors.lastname: Shukla
authors.affiliation: Division of vascular and interventional radiology, department of radiology, Mount Sinai Beth Israel, first avenue at Sixteenth Street, 10010 New York, United States.
authors.forename: M K
authors.initials: MK
authors.lastname: Kolber
authors.affiliation: Division of vascular and interventional radiology, department of radiology, Mount Sinai Beth Israel, first avenue at Sixteenth Street, 10010 New York, United States.
authors.forename: A
authors.initials: A
authors.lastname: Kumar
authors.affiliation: Division of vascular and interventional radiology, department of radiology, Mount Sinai Beth Israel, first avenue at Sixteenth Street, 10010 New York, United States. Electronic address: rapatel@chpnet.org.
authors.forename: R I
authors.initials: RI
authors.lastname: Patel
mesh_terms: D004434:Early Ambulation; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging*; D006489:Hemostatic Techniques; D006801:Humans; D008297:Male; D008875:Middle Aged; D061214:Patient Safety; D011677:Punctures / Q000379:methods*; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional; D014656:Vascular Surgical Procedures
keywords: Arterial access; Arterial access-related complications; Femoral low angle arterial access technique (FLAT); Ultrasound guidance