PMID- 29489670
OWN - NLM
STAT- MEDLINE
DCOM- 20180313
LR  - 20210109
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 9
DP  - 2018 Mar
TI  - Body mass index and the risk of low femoral artery puncture in coronary 
      angiography under fluoroscopy guidance.
PG  - e0070
LID - 10.1097/MD.0000000000010070 [doi]
LID - e0070
AB  - The inferior border of the femoral head (IBFH) is widely used as a landmark in 
      femoral artery puncture during invasive coronary angiography (ICA). However, 
      application of this technique can be challenging especially in obese patients. 
      This study was performed to investigate the association between body mass index 
      (BMI) and the risk of low puncture in femoral artery puncture.A total of 464 
      patients (64.8 +/- 11.1 years, 55.8% male) who underwent ICA via trans-femoral 
      access were retrospectively reviewed. IBFH was used as a landmark for a skin nick 
      and the femoral artery cannulation site was confirmed by femoral angiography. 
      Cannulation at the bifurcation of the common femoral artery (CFA) or below were 
      considered low puncture.Twenty-nine patients (5.8%) were identified as having an 
      angiographically high CFA bifurcation and low femoral artery puncture occurred in 
      27 (93.1%) patients of them. Among patients with normal bifurcation (n = 464), 
      low puncture occurred in 74 (15.9%) patients. Underweight (BMI < 18.5 kg/m) or 
      obese (BMI >/= 30 kg/m) patients were more common in the low puncture group than in 
      the proper puncture group (36.5% vs. 5.9%, P < .001). Multivariable analysis 
      showed underweight or obesity (odd ratio, 9.10; 95% confidential interval, 
      4.77-17.35; P < .001) was an independent risk factor of low puncture even after 
      controlling for clinical covariates. The average distance from IBFH to the CFA 
      puncture site was shorter in patients with underweight (1.74 +/- 0.71 cm) or 
      obesity (1.75 +/- 0.60 cm) than in those with normal BMI or overweight 
      (2.07 +/- 0.83 cm) (P = .030). Trigonometric calculation showed that the average 
      distance from IBFH to the CFA puncture site was 0.5 to 2.59 cm (mean = 1.32 cm) 
      shorter in underweight patients compared with those of normal weight or 
      overweight patients.In patients with normal CFA bifurcation, underweight or 
      obesity were associated with increased risk of low puncture. The puncture site 
      should be chosen about 1 finger width more proximal to IBFH for ICA in such 
      patients.
FAU - Kim, Minsuk
AU  - Kim M
AD  - Division of Cardiology, Department of Internal Medicine, Seoul National 
      University Bundang Hospital, Seongnam Seoul National University College of 
      Medicine Division of Cardiology, Department of Internal Medicine, Boramae Medical 
      Center, Seoul, Korea.
FAU - Kim, Myung-A
AU  - Kim MA
FAU - Kim, Hack-Lyoung
AU  - Kim HL
FAU - Lee, Won-Jae
AU  - Lee WJ
FAU - Lim, Woo-Hyun
AU  - Lim WH
FAU - Seo, Jae-Bin
AU  - Seo JB
FAU - Kim, Sang-Hyun
AU  - Kim SH
FAU - Zo, Joo-Hee
AU  - Zo JH
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - IM
MH  - Aged
MH  - *Body Mass Index
MH  - Catheterization, Peripheral/*adverse effects
MH  - Coronary Angiography/*adverse effects
MH  - Female
MH  - Femoral Artery/*injuries
MH  - Fluoroscopy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Overweight
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Thinness
MH  - Vascular System Injuries/*etiology
PMC - PMC5851760
COIS- The authors have no funding and conflicts of interest to disclose.
EDAT- 2018/03/01 06:00
MHDA- 2018/03/14 06:00
PMCR- 2018/03/02
CRDT- 2018/03/01 06:00
PHST- 2018/03/01 06:00 [entrez]
PHST- 2018/03/01 06:00 [pubmed]
PHST- 2018/03/14 06:00 [medline]
PHST- 2018/03/02 00:00 [pmc-release]
AID - 00005792-201803020-00031 [pii]
AID - MD-D-17-07316 [pii]
AID - 10.1097/MD.0000000000010070 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2018 Mar;97(9):e0070. doi: 10.1097/MD.0000000000010070.