021 - A Temporal Analysis of Technical Videos for Common Femoral Artery Access
Ocean Setia, MD – Resident, Dept. of Surgery (Vascular), Yale University School of Medicine; Juan Carlos Perez Lozada, MD – Associate Professor, Dept. of Radiology and Biomedical Imaging, Yale University School of Medicine; Hamid Mojibian, MD – Associate Professor, Dept. of Radiology and Biomedical Imaging, Yale University School of Medicine; Charles Matouk, MD – Associate Professor, Dept. of Neurosurgery, Yale University School of Medicine; Carlos Mena-Hurtado, MD – Associate Professor, Dept. of Medicine (Cardiology), Yale University School of Medicine; Jonathan Cardella, MD – Assistant Professor, Dept. of Surgery (Vascular), Yale University School of Medicine; Raul Guzman, MD – Professor, Dept. of Surgery (Vascular), Yale University School of Medicine; Cassius Iyad Ochoa Chaar, MD, MS – Associate Professor, Dept. of Surgery (Vascular), Yale University School of Medicine
Purpose: The common femoral artery is the most used access site among various endovascular specialties including interventional radiology, vascular surgery, neurosurgery, and cardiology. The internet has become a common resource for medical education but the quality of technical videos for femoral access publicly available has not been assessed. Yet, the techniques of femoral access continue to evolve. The goal of this study was to review the available technical videos for femoral access on the internet and examine their evolution.
Material and Methods: A Google search using term combinations denoting femoral access was conducted. All videos were reviewed to include technical illustration. The date of publication, specialty of operator, and characteristics of the technique as well as media were captured. A comparison between the early (2011-2016) and contemporary (2017-2021) periods of publication was performed.
Results: Out of 398 videos, 16 met inclusion criteria. The most common operators were cardiologists (66.7%) with absence of multidisciplinary videos. Vascular surgeons were the specialists in one third of the videos with no significant difference between the two periods. There were a total of 703,804 views of all videos combined, with a trend to higher number of views and likes for videos from the early period. Live patient and pictorial demonstrations were used in both periods. Only 12.5% of videos did not use any image guidance and relied on palpate-and-stick technique. However, videos using dual imaging (fluoroscopy and ultrasound) significantly increased in the contemporary period (0 vs 62.5%, P=0.025). The description of anatomical landmarks including the inguinal ligament and the use of micropuncture did not change. There was a trend towards gaining access at the optimal puncture site over the lower half of the femoral head that did not reach statistical significance (37.5% vs 75%, P=0.315).
Conclusions: This study reveals a technical evolution towards dual-image guidance for obtaining femoral access. Videos for femoral access are highly viewed on the internet and could serve as an important dissemination tool. A multidisciplinary universal femoral access video could bridge the technical gaps between different operators and improve patient care.