NEW YORK (Reuters Health) – A simple ultrasound examination of the femoral artery puncture site before elective percutaneous coronary intervention decreases the rate of subsequent vascular complications, a German team reports in the American Journal of Cardiology online August 22.

“Thus, there exists an easy tool to increase the safety of cardiac catheterizations using the transfemoral approach,” conclude Dr. Emilia Stegemann, at RWTH Aachen University, and colleagues.

They note that vascular complications, the most frequent adverse event associated with PCI, can be reduced with real-time ultrasound-guided puncture of the femoral artery, but this is difficult to perform in the catheterization lab.

The team therefore looked into the value of a pre-intervention ultrasound examination, in a study of all 848 patients at their institution undergoing PCI via the transfemoral approach over a 1-year period.

As described in the report, the patients received a clinical and ultrasound examination of the groin and legs on the day before PCI. The site of the femoral bifurcation and presence, extent, and location of plaques and stenosis were directly marked on the skin.

With this strategy, the rate of vascular complications at the access site was 1.9%. That compares to 4.2% in a control group of patients who underwent elective PCIs without pre-intervention ultrasound before the study (odds ratio 0.44; p=0.005), according to the report.

Dr. Stegemann and colleagues conclude that they have verified a significant decrease in vascular complications using ultrasound examination of the puncture site before PCI.

Summing up, they write, “ The major advantages are that (1) no additional time or equipment is required in the catheterization laboratory; (2) the examination is noninvasive, available, and feasible with minimal expenditure of time; and (3) skin markings of the bifurcation of the common femoral artery and those of the presence, extent, and location of plaques support interventionists in optimizing localization of the puncture without giving up familiar techniques such as anatomic landmark guidance or fluoroscopic guidance.”

Reference:
Effect of Preinterventional Ultrasound Examination on Frequency of Procedure-Related Vascular Complications in Percutaneous Coronary Interventions With Transfemoral Approach
Am J Cardiol 2011.