Comparison of Ultrasound Guided and Manual Palpation Methods in Retrograde Femoral Artery Catheterization: A Retrospective Study

Emre Can Çelebioğlu; Mehmet Cahit Sarıcaoğlu; Ayça Koca; Evren Özçınar; Levent Yazıcıoğlu

doi:10.5455/ajdi.20211122072917

Abstract
Background:
The purpose of this study is to assess the success and complication rates of two different techniques used for retrograde femoral artery access.
Methods:
This retrospective study included angiographies performed by a retrograde femoral artery access. Arterial punctures were performed with either ultrasound guided (group 1) or manual palpation (group 2) methods. Patient pulses were examined by a nurse practitioner and graded subjectively before preparing the puncture side (grade 0-3). The puncture side (right or left femoral), complications, average catheterization time calculated from patient notes, first pass success rate, and the number of puncture attempts were analyzed. Sheath sizes, BMI, vascular closure device usage after the angiographic procedure were also recorded and analyzed.
Results:
A total of 256 angiographies found to be eligible; age, pulse grading, and puncture side distributions were similar (p > 0.05). Mean puncture attempts to catheterize femoral arteries were 1.09 ± 0.09 and 1.25 ± 0.24 times, which took 1.49 ± 0.19 and 1.75 ± 0.25 mins for group 1 and group 2, respectively, which were statistically significant (p<0.001). Complication rates were similar for both groups (p=0.561) and increased with BMI>35 (p=0.003).
Conclusion:
Ultrasound guidance is comparable with manual palpation method and somewhat better in certain conditions. Thus should be considered as an option during routine retrograde femoral artery access. According to our results, even in arteries with strong pulse first-pass success rate, average catheterization time, and puncture attempts were better with ultrasound guidance.

Key words: Ultrasound guided femoral artery catheterization, manual palpation method, retrograde femoral artery puncture, vascular closure device, inguinal ligament