A prospective, randomized study comparing ultrasound versus fluoroscopic guided femoral arterial access in noncardiac vascular patients
The aim of our prospective, single-center, randomized study was to compare the procedural outcomes and complication rates of ultrasound (US)-guided common femoral artery (CFA) access to fluoroscopic guidance in noncardiac procedures. A total of 635 patients undergoing femoral access for noncardiac d...
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| Veröffentlicht in: | Journal of vascular surgery 2020-07, Vol.72 (1), p.259-267 |
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| creator | Stone, Patrick Campbell, John Thompson, Stephanie Walker, Jerri |
| description | The aim of our prospective, single-center, randomized study was to compare the procedural outcomes and complication rates of ultrasound (US)-guided common femoral artery (CFA) access to fluoroscopic guidance in noncardiac procedures.
A total of 635 patients undergoing femoral access for noncardiac diagnostic or interventional procedures were randomized 1:1 to receive either fluoroscopic or US-guided access. The primary end point of the study was successful CFA cannulation. Secondary end points included the first-pass success rate, time to sheath insertion, and accidental venipunctures rate. Both short (24 hours) and midterm (30-90 days postprocedure) access complications were assessed by practitioners blinded to patient randomization.
Successful CFA cannulation occurred in 93% of US-guided procedures compared with 86% of fluoroscopy-guided access (P = .002). US guidance was associated with increased rates of first-attempt success (74% vs 42%; P |
| doi_str_mv | 10.1016/j.jvs.2019.09.051 |
| format | Article |
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A total of 635 patients undergoing femoral access for noncardiac diagnostic or interventional procedures were randomized 1:1 to receive either fluoroscopic or US-guided access. The primary end point of the study was successful CFA cannulation. Secondary end points included the first-pass success rate, time to sheath insertion, and accidental venipunctures rate. Both short (24 hours) and midterm (30-90 days postprocedure) access complications were assessed by practitioners blinded to patient randomization.
Successful CFA cannulation occurred in 93% of US-guided procedures compared with 86% of fluoroscopy-guided access (P = .002). US guidance was associated with increased rates of first-attempt success (74% vs 42%; P < .001), fewer inadvertent venipunctures (2% vs 10 %; P < .001), and decreased median time to cannulation (80 vs 100 seconds; P < .001) compared with fluoroscopy. Rates of complications did not differ at 24 hours (1% vs 1%; P = .99) or 30 to 90 days (2% vs 4%; P = .15) in fluoroscopy vs US-guided access. When access was performed by vascular surgery trainees (residents and fellows), US guidance retained superior rates of successful CFA cannulation compared to fluoroscopy guided access (n = 298; 96% vs 89%; P = .03). Trainees' time to achieve CFA cannulation was similar to attendings' when using US guidance (median, 85 vs 77 seconds; P = .14); however, with fluoroscopy, trainees' times were significantly longer than those of attendings (137 vs 86 seconds; P = .001).
In comparison to fluoroscopy, US-guided CFA cannulation had a higher rate of success, faster cannulation, and fewer venipunctures in the absence of increased complications.</description><identifier>ISSN: 0741-5214</identifier><identifier>EISSN: 1097-6809</identifier><identifier>DOI: 10.1016/j.jvs.2019.09.051</identifier><identifier>PMID: 31980242</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Femoral artery access ; Fluoroscopy ; Groin complications ; Peripheral vascular disease ; Ultrasound-guided femoral artery</subject><ispartof>Journal of vascular surgery, 2020-07, Vol.72 (1), p.259-267</ispartof><rights>2019 Society for Vascular Surgery</rights><rights>Copyright © 2019 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c396t-2f041d987b2938eeff447174e92b8cf4f606a88ab368bb2fc34a823023ec18673</citedby><cites>FETCH-LOGICAL-c396t-2f041d987b2938eeff447174e92b8cf4f606a88ab368bb2fc34a823023ec18673</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jvs.2019.09.051$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3548,27922,27923,45993</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31980242$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Stone, Patrick</creatorcontrib><creatorcontrib>Campbell, John</creatorcontrib><creatorcontrib>Thompson, Stephanie</creatorcontrib><creatorcontrib>Walker, Jerri</creatorcontrib><title>A prospective, randomized study comparing ultrasound versus fluoroscopic guided femoral arterial access in noncardiac vascular patients</title><title>Journal of vascular surgery</title><addtitle>J Vasc Surg</addtitle><description>The aim of our prospective, single-center, randomized study was to compare the procedural outcomes and complication rates of ultrasound (US)-guided common femoral artery (CFA) access to fluoroscopic guidance in noncardiac procedures.
A total of 635 patients undergoing femoral access for noncardiac diagnostic or interventional procedures were randomized 1:1 to receive either fluoroscopic or US-guided access. The primary end point of the study was successful CFA cannulation. Secondary end points included the first-pass success rate, time to sheath insertion, and accidental venipunctures rate. Both short (24 hours) and midterm (30-90 days postprocedure) access complications were assessed by practitioners blinded to patient randomization.
Successful CFA cannulation occurred in 93% of US-guided procedures compared with 86% of fluoroscopy-guided access (P = .002). US guidance was associated with increased rates of first-attempt success (74% vs 42%; P < .001), fewer inadvertent venipunctures (2% vs 10 %; P < .001), and decreased median time to cannulation (80 vs 100 seconds; P < .001) compared with fluoroscopy. Rates of complications did not differ at 24 hours (1% vs 1%; P = .99) or 30 to 90 days (2% vs 4%; P = .15) in fluoroscopy vs US-guided access. When access was performed by vascular surgery trainees (residents and fellows), US guidance retained superior rates of successful CFA cannulation compared to fluoroscopy guided access (n = 298; 96% vs 89%; P = .03). Trainees' time to achieve CFA cannulation was similar to attendings' when using US guidance (median, 85 vs 77 seconds; P = .14); however, with fluoroscopy, trainees' times were significantly longer than those of attendings (137 vs 86 seconds; P = .001).
In comparison to fluoroscopy, US-guided CFA cannulation had a higher rate of success, faster cannulation, and fewer venipunctures in the absence of increased complications.</description><subject>Femoral artery access</subject><subject>Fluoroscopy</subject><subject>Groin complications</subject><subject>Peripheral vascular disease</subject><subject>Ultrasound-guided femoral artery</subject><issn>0741-5214</issn><issn>1097-6809</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp9kc2KFTEQhYMoznX0AdxIli7sa_66O42rYfAPBtzoOqSTypBLd6dNdRrGF_C1zeWOLoWCqsU5B85XhLzm7MgZ796fjqcdj4Lx4cjqtPwJOXA29E2n2fCUHFiveNMKrq7IC8QTY5y3un9OriQfNBNKHMjvG7rmhCu4Le7wjma7-DTHX-ApbsU_UJfm1ea43NMybdliKounO2QsSMNUUjW7tEZH70v01RVgTtlO1OYNcjwfzgEijQtd0uJs9tE6ult0ZbKZrnaLsGz4kjwLdkJ49bivyY9PH7_ffmnuvn3-entz1zg5dFsjAlPcD7ofxSA1QAhK9bxXMIhRu6BCxzqrtR1lp8dRBCeV1UIyIcFx3fXymry95NbWPwvgZuaIDqbJLpAKGiFV27JOSVal_CJ1tSNmCGbNcbb5wXBmzvzNyVT-5szfsDotr543j_FlnMH_c_wFXgUfLgKoJfcI2aCrABz4mOsPjE_xP_F_AITHmak</recordid><startdate>20200701</startdate><enddate>20200701</enddate><creator>Stone, Patrick</creator><creator>Campbell, John</creator><creator>Thompson, Stephanie</creator><creator>Walker, Jerri</creator><general>Elsevier Inc</general><scope>6I.</scope><scope>AAFTH</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20200701</creationdate><title>A prospective, randomized study comparing ultrasound versus fluoroscopic guided femoral arterial access in noncardiac vascular patients</title><author>Stone, Patrick ; Campbell, John ; Thompson, Stephanie ; Walker, Jerri</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c396t-2f041d987b2938eeff447174e92b8cf4f606a88ab368bb2fc34a823023ec18673</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Femoral artery access</topic><topic>Fluoroscopy</topic><topic>Groin complications</topic><topic>Peripheral vascular disease</topic><topic>Ultrasound-guided femoral artery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Stone, Patrick</creatorcontrib><creatorcontrib>Campbell, John</creatorcontrib><creatorcontrib>Thompson, Stephanie</creatorcontrib><creatorcontrib>Walker, Jerri</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of vascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Stone, Patrick</au><au>Campbell, John</au><au>Thompson, Stephanie</au><au>Walker, Jerri</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A prospective, randomized study comparing ultrasound versus fluoroscopic guided femoral arterial access in noncardiac vascular patients</atitle><jtitle>Journal of vascular surgery</jtitle><addtitle>J Vasc Surg</addtitle><date>2020-07-01</date><risdate>2020</risdate><volume>72</volume><issue>1</issue><spage>259</spage><epage>267</epage><pages>259-267</pages><issn>0741-5214</issn><eissn>1097-6809</eissn><abstract>The aim of our prospective, single-center, randomized study was to compare the procedural outcomes and complication rates of ultrasound (US)-guided common femoral artery (CFA) access to fluoroscopic guidance in noncardiac procedures.
A total of 635 patients undergoing femoral access for noncardiac diagnostic or interventional procedures were randomized 1:1 to receive either fluoroscopic or US-guided access. The primary end point of the study was successful CFA cannulation. Secondary end points included the first-pass success rate, time to sheath insertion, and accidental venipunctures rate. Both short (24 hours) and midterm (30-90 days postprocedure) access complications were assessed by practitioners blinded to patient randomization.
Successful CFA cannulation occurred in 93% of US-guided procedures compared with 86% of fluoroscopy-guided access (P = .002). US guidance was associated with increased rates of first-attempt success (74% vs 42%; P < .001), fewer inadvertent venipunctures (2% vs 10 %; P < .001), and decreased median time to cannulation (80 vs 100 seconds; P < .001) compared with fluoroscopy. Rates of complications did not differ at 24 hours (1% vs 1%; P = .99) or 30 to 90 days (2% vs 4%; P = .15) in fluoroscopy vs US-guided access. When access was performed by vascular surgery trainees (residents and fellows), US guidance retained superior rates of successful CFA cannulation compared to fluoroscopy guided access (n = 298; 96% vs 89%; P = .03). Trainees' time to achieve CFA cannulation was similar to attendings' when using US guidance (median, 85 vs 77 seconds; P = .14); however, with fluoroscopy, trainees' times were significantly longer than those of attendings (137 vs 86 seconds; P = .001).
In comparison to fluoroscopy, US-guided CFA cannulation had a higher rate of success, faster cannulation, and fewer venipunctures in the absence of increased complications.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>31980242</pmid><doi>10.1016/j.jvs.2019.09.051</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of vascular surgery, 2020-07, Vol.72 (1), p.259-267 |
| issn | 0741-5214 1097-6809 |
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| source | ScienceDirect Journals (5 years ago - present); EZB-FREE-00999 freely available EZB journals |
| subjects | Femoral artery access Fluoroscopy Groin complications Peripheral vascular disease Ultrasound-guided femoral artery |
| title | A prospective, randomized study comparing ultrasound versus fluoroscopic guided femoral arterial access in noncardiac vascular patients |
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