Double Uncture fo Single Common Femoral Artery for CT Hepatic Arteriography and CT Arterial Portography

ABSTRACT

PURPOSE: To evaluate the safety and efficacy of double puncture of a single common femoral artery for CThepatic arteriography(CTHA) and CT arterial portography(CTAP) in patients with hepatocellular carcinoma. MATERIAL AND METHODS: Between October and December 1995, 35 patients with hepatocellular carcinoma underwent doublepuncture of a single common femoral artery for combined CTHA and CTAP. Preangiographic laboratory data were asfollows platelet count from 28,000 to 250,000/mm3 (average, 124,500/mm3) ; prothrombin time from 45.8% to100%(average, 85.3%). In the inguinal area, a pair of 21G puncture needles were used unilaterally for the firsttwo femoral punctures, at a distance of 5-7mm ; a 0.018" guidewire for the insertion of a 4-F sheath in a coaxialmicropuncure introducer set ; and a 0.035" guidewire and 4 F check-flo sheath for the insertion of 4-F catheters.After being moved to the CT room, patients then underwent spiral CTHA and CTAP for further detection ofhepatocellular carcinoma nodules. Transarterial chemoembolization followed, and the punctured site was thencompressed by the usual finger compression method. After initial compression and one day later, we observed thepuncture site for complications such as hematoma formation, thromboembolization or arteriovenous fistula ; ect. RESULTS: Except for the formation of two mild hematomas, no remarkable severe complications were noted. Fifteenpatients who had previously undergone combined spiral CTHA and CTAP using the bilateral femoral puncture method(with a 5-F check-flo sheath) felt more comfortable than when an earlier method was used. CONCLUSION: For combinedCTHA and CTAP, double puncture of a single common femoral artery is safer and more comfortable than the bilateralfemoral puncture method.