Which is NOT true about femoral aery cannulation?
Single wall puncture is indicated in those with normal coagulation profile Single wall puncture is indicated in those with coagulopathy as there is more risk of bleeding in double wall puncture technique. Aerial access is obtained for hemodynamic monitoring (blood pressure monitoring, blood gases monitoring) in an intensive care unit, or for the purpose of aeriography and intervention as in vascular surgical patients. The femoral aery is one of the most frequently cannulated aeries in the body. It is commonly used for aerial access for the purpose of aeriography in the vascular surgical patient. It is a large-caliber vessel that is appropriate for using the larger-profile devices for angioplasty and stenting of the peripheral vessels. It is also commonly used in cardiac catheterization for the purpose of coronary angiography and for coronary interventions. The radial aery is the most frequently used site of aerial cannulation for hemodynamic monitoring because it is technically easy to cannulate and has a low complication rate, in pa due to the good collateral circulation of the hand. The femoral aery is the second most cannulated aery for haemodynamic monitoring. It provides a more accurate estimation of central (aoic) pressure than the radial aery. Its large-caliber is appropriate for using the larger-profile devices for angioplasty and stenting of the peripheral vessels. Femoral aery catheter complications are infrequent but are more complicated than that of the radial aery. For femoral aerial access, the puncture is made in the common femoral aery. A puncture site above the inguinal ligament, in the external iliac aery, or distally in the superficial femoral or profunda femoris aery is problematic. Disadvantage of external iliac aery: - The external iliac aery is located in the retroperitoneal space, making this aery difficult, to compress and achieve postprocedure hemostasis. (a puncture in this region can result in potentially catastrophic complication of retroperitoneal hemorrhage.) Disadvantage with superficial femoral or external iliac aery: - these aeries are substantially smaller in caliber and have a higher incidence of postprocedure thrombosis. - higer incidence of pseudoaneurysm - Additionally, the superficial .femoral aery is often heavily diseased. Localization of Common femoral aery (CFA): The CFA begins immediately behind the inguinal ligament, midway between the anterior superior spine of the ilium and the symphysis pubis. (A line connecting these two bony structures represents the inguinal ligament) Just below the inguinal ligament (one to two fingerbreadths distal to the inguinal ligament) the aery is closest to the surface of the skin and easily accessible. This is the optimal location of cannulation. The femoral aery is identified in the inguinal region by its pulsation. If fluoroscopy is being used, the femoral aery is typically located over the medial third of the femoral head. Note that the groin crease is unreliable in locating the ideal site of puncture and should not be used as a landmark. Femoral aery cannulation can be done using the Seldinger technique. The Seldinger technique is a medical procedure to obtain safe access to blood vessels (both aeries and veins) and other hollow organs. There are two methods of aerial wall puncture: the double-wall puncture and the single-wall puncture. The double-wall puncture involves penetrating both the anterior and posterior walls with the needle and then withdrawing the needle slowly until pulsatile blood flow is confirmed. This method is associated with a higher incidence of complications but is relatively easier. In the single-wall puncture technique, only the anterior wall of the aery is punctured with the needle, which is confirmed by pulsatile blood flow through the needle. Single wall puncture is usually the recommended technique. These two techniques can be used interchangeably and depends on the operator's preference, however-Single wall puncture is indicated in patients with coagulopathy or if thrombolysis is planned because of the increased risk of bleeding in double wall technique. Complications of femoral aery cannulation: - haemorrhage - Aeriovenous.fistulae - aerial dissection - pseudoaneurysm - aerial thrombosis
Common femoral aery is cannulated
Single wall puncture is indicated in those with normal coagulation profile
Femoral aery is catheterised at medial third of femoral head
Seldinger technique is used both for femoral aery and vein