Optimal Technique For Antegrade Femoral Artery Puncture.

Abstract

With the advent of trans luminal popliteo-femoral angioplasty, lower limb arterial embolization for malignancy, catheter placement of intra-arterial thrombolysis and intra-arterial chemotherapy, optimal technique for antegrade femoral artery puncture has gained a crucial importance. The main object of our study was to devise an easier, convenient and accurate method to get a clean vessel wall antegrade puncture in the first attempt, at a safe level along femoral artery. The femoral artery puncture at the level of common femoral artery puncture was highly desirable as common femoral artery has larger caliber, best osseous support of femoral head and is in direct line of the superficial femoral artery. A constant landmark to identify the optimal level of entry into the common femoral artery would be helpful. On the basis of our data obtained from 50 patients, we conclude that beginning of common femoral artery is located proximal to the center of femoral head and the femoral artery bifurcation is located distal to the center of femoral head. If the arterial entry is chosen at the level of center of femoral head which is localized by fluoroscopy a safe puncture of common artery is ensured. With skin puncture site 1-2 cm proximal to this level needle is directed obliquely through the skin, the common femoral artery is entered at the level of center of femoral head.