Optimizing Common Femoral Artery Access

Common femoral artery (CFA) access is an important step of many vascular interventional procedures such as peripheral arterial, aortic, and endovascular oncologic interventions. The anatomical location of the CFA as it crosses over the femoral head provides a unique location to establish a relatively large arterial access to a vessel that is conveniently located near the aorta and its major branches. A proper access helps the interventionist with the remainder of the procedure and diminishes the risk of severe complications leading to surgery, thrombolysis, patient morbidity, or occasionally mortality. On the contrary, a suboptimal access can jeopardize the entire procedure and may lead to limb and life-threatening complications. With the introduction of ultrasonography-assisted CFA access, the process has become more predictable and possibly less adventurous; however, there remain tips and tricks that can guarantee a safe and proper start for any arterial procedure. We review the preprocedural evaluation, procedural techniques, and postprocedural care to optimize CFA access.