Ultrasound Guided Common Femoral Artery Access: A Meta-Analysis and Systematic Review

Background: Common femoral artery vascular access is commonplace in all forms of interventional procedures including coronary, peripheral vascular and cerebrovascular. Ultrasound guided arterial access is not the standard of care as in central venous access. Current studies are not conclusive and there remains considerable variation in clinical practice. This meta-analysis aimed to determine the potential benefits of ultrasound guidance in preventing access complications and inefficiencies. Method(s): Embase, Medline and the Cochrane Central Registry were searched for randomised controlled trials evaluating ultrasound guided versus palpation or fluoroscopy assisted common femoral access for any interventional procedures. A random effects meta-analysis was used to evaluate haematoma or pseudoaneurysm formation as well as number of attempts required for access. Result(s): 228 abstracts were identified from which six studies were included for meta-analysis, totaling 2492 participants. Ultrasound use was associated with a significant reduction in haematomas and pseudoaneurysms (RR 0.42, 95% CI: 0.24 to 0.72, p<0.002) as well as puncture attempts with 0.63 less needle passes required on average (95% CI: -1.18 to -0.08, p=0.03). Conclusion(s): The routine use of ultrasound guided common femoral artery access significantly reduces bleeding complications and the number of attempts required for successful access. This should be recommended as a standard procedure. Routine use would likely overcome the learning curve to facilitate uncomplicated access in more difficult cases.

Publication History

Article published online:
11 May 2021