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Abstract
Purpose
To determine the optimal skin site for retrograde common femoral arterial puncture based on the inguinal skin crease.
Materials and Methods
We retrospectively evaluated CT arteriographic images of right groins in 200 patients. We measured the relative distances of the common femoral artery bifurcation and inguinal ligament from the inguinal skin crease, respectively. We calculated the rates of common femoral artery puncture at 1 mm intervals, above or below the inguinal skin crease.
Results
The range in skin site where the rates of common femoral artery puncture were greater than 60%, 70%, and 80% were situated between 3 mm below to 27 mm above, 1 mm to 23 mm above, and 5 mm to 15 mm above the inguinal skin crease, respectively. The skin site of the highest puncture rate was 10 mm above inguinal skin crease (85.2%).
Figures and Tables
Fig. 1
Three-dimensional images of inguinal skin crease (ISC) and femoral artery
A. A volume-rendering image shows the ISC at anteroposterior
projection.
B. A volume-rendering images shows the measurement methods
of reference intersecting points (A, B, C) and horizontal lines
(A, B, C) at anteroposterior view.
A thick oblique line means ISC and a dotted oblique line means
inguinal ligament (IL).
Point A: intersecting point between inguinal ligament and
femoral artery,
Point B: CFA bifurcation,
Point C: intersecting point between inguinal skin crease and
femoral artery,
Line A: horizontal line, passing Point A,
Line B: horizontal line, passing Point B (CFA bifurcation),
Line C: horizontal line, passing Point C,
C. The CFA and re-established skin puncture site on a sagittal view
Point A`= Point A - skin depth of Point A
Point B`= Point B - skin depth of Point B
Fig. 2
The Graph shows the arterial puncture rate at each distance above or below the inguinal skin crease (SC). The distance with the highest percentage of common femoral artery (CFA) puncture rate was 10 mm above the inguinal skin crease in 85.2% of the cases. The ranges of optimal skin site for retrograde common femoral arterial puncture rates of more than 60%, 70% and 80% of CFA puncture rate was from 3 mm below to 27 mm above, from 1 mm to 23 mm above, and from 5 mm to 15 mm above, respectively.
(SFA : superficial femoral artery, EIA : external iliac artery)
References
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