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

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 retrograde femoral artery access. Arterial punctures were performed with either ultrasound guided (group 1) or manual palpation (group 2) methods. Patients’ pulses were examined by a nurse practitioner and graded subjectively before preparing the puncture side (grade 0–3). Arterial puncture performed through a strong(3) or medium pulsed(2) artery was included in this study. The puncture side (right or left femoral), complications, average catheterization time calculated from patients’ notes, first-pass success rate, and the number of puncture attempts were analyzed. Sheath sizes, body mass index (BMI), and, vascular closure device usage after the angiographic procedure were also recorded and analyzed. Results: A total of 256 angiographies were found to be eligible; age, pulse grading, and puncture side distributions were similar ( p > 0.05). Mean puncture attempts to cathe-terize femoral arteries were 1.09 ± 0.09 and 1.25 ± 0.24 times, which took 1.49 ± 0.19 and 1.75 ± 0.25 minutes 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 the manual palpation method and is somewhat better in certain conditions. Thus, it should be considered as an option during routine retrograde femoral artery access. According to our results, even in arteries with strong pulses, first-pass success rate, average catheterization time, and puncture attempts were better with ultrasound guidance.