A novel fluoroscopic-guided technique with micropuncture needle for the common femoral artery access

Massoud A. Leesar, Firas Al Solaiman, Amir Azarbal, Kostas Marmagkiolis, Mehmet Cilingiroglu

    Research output: Contribution to journalArticle

    Abstract

    Background: Randomized trials demonstrated that the rate of access to the center of the CFA was low and not different with fluoroscopy vs. anatomic landmarks. We investigated the role a novel fluoroscopic-guided technique with the micropuncture needle (MPN) for the common femoral artery (CFA) access. Methods: A MPN was advanced to the center of pubis in the 20° ipsilateral right- or left anterior oblique view for the CFA access in 150 patients undergoing cardiac catheterization. After the CFA puncture and guidewire advancement, if the MPN tip was within pelvic-femoral line (the line between pelvic brim and inferior border of the femoral head), a sheath was inserted into the CFA and femoral angiography was performed. The acceptable sites of CFA access were defined zone III, as the sheath position in the middle third of the CFA; Zone II, between the pelvic brim and Zone III; and Zone IV, between the femoral bifurcation and Zone III. High or low access sites were zones I and V, respectively. Results: The primary-end point, the CFA access to the center of CFA (zone III) was significantly higher than zones II and IV (64% vs. 13% and 23%; P < 0.001, respectively). The MPN tip was high or low in 17 and 11 patients (19%), respectively, which was readvanced to the center of pubis using fluoroscopy; this resulted in CFA access in 100% of patients. There were no bleeding complications; the baseline and next day hemoglobin levels were 13.0 ± 2.0 g/dl vs. 12.4 ± 1.9 g/dl, respectively; P = NS. Conclusions: The use of this novel fluoroscopic-guided technique with the MPN resulted in access to the CFA in all patients and to the center of the CFA in the majority of patients. There was no significant hemoglobin drop or bleeding complications after the procedure.

    Original languageEnglish (US)
    JournalCardiovascular Revascularization Medicine
    DOIs
    StateAccepted/In press - Jan 1 2019

    Fingerprint

    Femoral Artery
    Punctures
    Needles
    Thigh
    Pubic Bone
    Fluoroscopy
    Hemoglobins
    Anatomic Landmarks
    Hemorrhage
    Cardiac Catheterization
    Angiography

    Keywords

    • Femoral access
    • Micropuncture needle
    • Novel technique

    ASJC Scopus subject areas

    • Cardiology and Cardiovascular Medicine

    Cite this

    A novel fluoroscopic-guided technique with micropuncture needle for the common femoral artery access. / Leesar, Massoud A.; Al Solaiman, Firas; Azarbal, Amir; Marmagkiolis, Kostas; Cilingiroglu, Mehmet.

    In: Cardiovascular Revascularization Medicine, 01.01.2019.

    Research output: Contribution to journalArticle

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    abstract = "Background: Randomized trials demonstrated that the rate of access to the center of the CFA was low and not different with fluoroscopy vs. anatomic landmarks. We investigated the role a novel fluoroscopic-guided technique with the micropuncture needle (MPN) for the common femoral artery (CFA) access. Methods: A MPN was advanced to the center of pubis in the 20° ipsilateral right- or left anterior oblique view for the CFA access in 150 patients undergoing cardiac catheterization. After the CFA puncture and guidewire advancement, if the MPN tip was within pelvic-femoral line (the line between pelvic brim and inferior border of the femoral head), a sheath was inserted into the CFA and femoral angiography was performed. The acceptable sites of CFA access were defined zone III, as the sheath position in the middle third of the CFA; Zone II, between the pelvic brim and Zone III; and Zone IV, between the femoral bifurcation and Zone III. High or low access sites were zones I and V, respectively. Results: The primary-end point, the CFA access to the center of CFA (zone III) was significantly higher than zones II and IV (64{\%} vs. 13{\%} and 23{\%}; P < 0.001, respectively). The MPN tip was high or low in 17 and 11 patients (19{\%}), respectively, which was readvanced to the center of pubis using fluoroscopy; this resulted in CFA access in 100{\%} of patients. There were no bleeding complications; the baseline and next day hemoglobin levels were 13.0 ± 2.0 g/dl vs. 12.4 ± 1.9 g/dl, respectively; P = NS. Conclusions: The use of this novel fluoroscopic-guided technique with the MPN resulted in access to the CFA in all patients and to the center of the CFA in the majority of patients. There was no significant hemoglobin drop or bleeding complications after the procedure.",
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    AU - Marmagkiolis, Kostas

    AU - Cilingiroglu, Mehmet

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