Department of Radiology, Konkuk University School of Medicine, Seoul, Republic of Korea.
Department of Thoracic and Cardiovascular Surgery, Konkuk University School of Medicine, Seoul, Republic of Korea.
J Vasc Access. 2021 May;22(3):364-369. doi: 10.1177/1129729820942053. Epub 2020 Jul 15.
The aim of this study was to evaluate the feasibility and safety of ultrasonography-guided antegrade common femoral artery puncture and subsequent superficial femoral artery access without the aid of fluoroscopy. Factors that could affect access time were also assessed.
A total of 294 cases from 218 consecutive patients (163 men, 55 women; mean age: 66.9 ± 12.7 years) who underwent lower extremity endovascular procedures were retrospectively evaluated. The time between the injection of local anesthetic and the insertion of the microsheath into the superficial femoral artery was measured. The common femoral artery diameter, cutis thickness, distance between arterial puncture site and common femoral artery bifurcation, degree of common femoral artery calcification, body mass index, and history of previous access were investigated to assess their relationship with access time. Furthermore, all cases were assessed with ultrasonography for access-site complications before discharge.
Technical success was achieved in 293 of 294 procedures (99.7%). The mean time for superficial femoral artery access was 1.9 ± 0.8 min (range, 0.7-3.7 min). Additional fluoroscopic guidance was needed in one case. There were moderately positive correlations of body mass index ( = 0.75; < 0.001) and cutis thickness ( = 0.58; < 0.001) with access time. The other variables failed to reveal significant correlations with access time. Five groin hematomas occurred after percutaneous transluminal angioplasty. Complications such as pseudoaneurysm, arteriovenous fistula, or retroperitoneal hematoma were not observed.
Antegrade common femoral artery puncture with subsequent superficial femoral artery access conducted solely under ultrasonography guidance was feasible and safe. In addition, the antegrade access time showed positive correlations with body mass index and cutis thickness.
本研究旨在评估在不使用透视的情况下，超声引导顺行股总动脉穿刺和随后的股浅动脉入路的可行性和安全性。还评估了可能影响入路时间的因素。
回顾性分析了 218 例连续患者（163 例男性，55 例女性；平均年龄：66.9±12.7 岁）中的 294 例接受下肢血管内治疗的患者。测量了从局部麻醉注射到将微鞘插入股浅动脉的时间。测量股总动脉直径、皮肤厚度、动脉穿刺部位与股总动脉分叉处的距离、股总动脉钙化程度、体重指数和既往入路史，以评估其与入路时间的关系。此外，所有病例在出院前均进行超声检查以评估入路部位并发症。
294 例手术均获得技术成功（99.7%）。股浅动脉入路的平均时间为 1.9±0.8 分钟（范围 0.7-3.7 分钟）。1 例需要额外的透视引导。体重指数（ = 0.75； < 0.001）和皮肤厚度（ = 0.58； < 0.001）与入路时间呈中度正相关。其他变量与入路时间无显著相关性。经皮腔内血管成形术后发生 5 例腹股沟血肿。未观察到假性动脉瘤、动静脉瘘或腹膜后血肿等并发症。
仅在超声引导下进行顺行股总动脉穿刺和随后的股浅动脉入路是可行和安全的。此外，顺行入路时间与体重指数和皮肤厚度呈正相关。
