High Deep Femoral Artery Bifurcation Can Disturb Safe Femoral Venous Access: CT Assessment in Patients Who Underwent Femoral Venous Access Under Doppler Ultrasound Guidance.

Autor:	Morita S; Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women's Medical University Hospital, Japan., Yamamoto T; Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women's Medical University Hospital, Japan., Kamoshida K; Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women's Medical University Hospital, Japan., Yamazaki H; Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women's Medical University Hospital, Japan., Yatabe M; Department of Medicine II, Endocrinology and Hypertension, Tokyo Women's Medical University Hospital, Japan., Ichihara A; Department of Medicine II, Endocrinology and Hypertension, Tokyo Women's Medical University Hospital, Japan., Sakai S; Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women's Medical University Hospital, Japan.
Jazyk:	angličtina
Zdroj:	Interventional radiology (Higashimatsuyama-shi (Japan) [Interv Radiol (Higashimatsuyama)] 2021 Jul 01; Vol. 6 (2), pp. 29-36. Date of Electronic Publication: 2021 Jul 01 (Print Publication: 2021).
DOI:	10.22575/interventionalradiology.2021-0001
Abstrakt:	Purpose: To retrospectively evaluate the variations of deep femoral artery (DFA) bifurcation on computed tomography (CT) and technical success in femoral venous access. Materials and Methods: CT images of 353 patients who underwent adrenal venous sampling were evaluated. Height with relation to the inferior border of the femoral head and direction of DFA bifurcations were classified as follows: type L, low bifurcation; type H1, high lateral bifurcation; type H2, high posterior to posterolateral bifurcation; type H3, high posteromedial bifurcation; and type H4, high medial bifurcation crossing in front of the femoral vein. Technical success and complications during femoral venous access were also evaluated. Results: The frequencies of types L, H1, H2, H3, and H4 were 82.7%, 9.1%, 6.9%, 0.4%, and 0.9%, respectively. In 92.2% of type H1 and 69.4% of type H2, the superior femoral artery displaced medially by the high DFA partially overlapped the femoral vein. Upon the inclusions of H3 and H4, in 14.4% of cases, the high DFAs could obstruct the access route to the femoral vein. Using Doppler ultrasound guidance, no significant differences were observed in the rates of success for puncture in the first attempt (84.5% vs. 75.4%, p = 0.122) and accidental arterial puncture (1.0% vs. 0%, p = 1.00) between low and high DFA bifurcations, respectively. Conclusions: High DFA bifurcation is observed in 17.3% of patients and could obstruct the access route to the femoral vein. This can be evaluated using Doppler ultrasound guidance to avoid accidental arterial puncture during femoral venous access. Competing Interests: The authors declare that they have no conflicts of interest to report. (© 2021 Japanese Society of Interventional Radiology.)
Databáze:	MEDLINE
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