A prospective randomized clinical trial of the use of fluoroscopy in obtaining femoral arterial access.

BACKGROUND

There is no consensus on the utility of fluoroscopy in obtaining common femoral artery (CFA) access.

METHODS

Patients weighing < 136.4 kg (300 lbs) with palpable femoral pulses undergoing coronary angiography were randomized to arterial access with or without the use of fluoroscopy (using the center of the femoral head as the optimal site to enter the artery).

RESULTS

208 patients were enrolled with 110 randomized to the palpation group and 98 were randomized to the palpation +fluoroscopy group. Mean age (+/- SD) was 60 +/- 11 years, 61% were male, 35% had diabetes, and 40% had a body mass index (BMI) > 30 kg/m(2). Clinical characteristics and procedural factors were similar among the two groups with the exception that fewer needle passes were required and access was achieved faster in the palpation group. Arterial puncture over the femoral head occurred in 91% of the palpation group versus 95% of the palpation + fluoroscopy group (p = 0.27). Successful CFA puncture occurred in 85% of the palpation group versus 90% of the palpation + fluoroscopy group (p = 0.49). Cannulation of the external iliac artery occurred in 1 patient in each group, whereas arterial puncture distal to the CFA bifurcation occurred in 16 (15%) of the palpation group and in 9 (9%) of the palpation + fluoroscopy group (p = 0.33).

CONCLUSION

In this single-center, randomized trial, the use of fluoroscopy did not increase the probability of arterial puncture over the femoral head or the rate of successful CFA cannulation.