Options of common femoral artery access for chronic lower limb ischemia endovascular treatment: Comparison between ultrasound versus anatomical guidance

Abstract

Background: One of the most frequent causes of illness and mortality is chronic lower limb ischemia. Most patients often report rest discomfort or intermittent claudication. In most cases, peripheral arterial disease (PAD) involves endovascular therapy along with adjunctive stenting, which is a well-acknowledged and utilized method for treating lower limb arterial endovascular disease. To achieve common femoral access, the traditional access process combines fluoroscopic guidance, anatomic landmarks, and palpation. To treat chronic lower limb ischemia using an endovascular approach, this study compares the use of ultrasound (US) against anatomical guides in common femoral artery access. According to the study’s findings, US guidance reduces access times, puncture tries, the incidence of venipunctures, the incidence of retroperitoneal hematomas, and local bruising during puncture to the femoral artery in the treatment of chronic lower limb ischemia by angioplasty. Patients and Methods: The 400 patients in this retrospective study had persistent lower limb ischemia. The research is carried out at Beni-Suef University Hospital’s Vascular Surgery unit from January 7, 2023, until January 9, 2023. For the last two years, from January 7, 2021, to January 7, 2023, statistics were gathered via patient registration data. Results: Compared with patients who underwent access to the femoral artery anatomically, the intraprocedure time required for femoral artery access was significantly shorter in those patients who underwent access to femoral artery access guided by US, also less morbidity like bruises, hematoma, and pseudoaneurysm was recorded in US-guided group. Conclusion: Routine US-guided femoral artery access was superior to anatomical-guided femoral access and improved CFA cannulation.