Research Article| Volume 32, ISSUE 3, 106976, March 2023

Factors related to high bifurcation level of common femoral artery



      Common femoral artery (CFA) puncture is performed for endovascular treatment. However, we sometimes experience branch punctures when the CFA bifurcation level is high. In this study, we examined the frequency of high CFA bifurcation level and related factors.


      The CFA bifurcation level was identified in 100 patients, who underwent cerebral angiography or endovascular treatment by femoral artery (FA) puncture, on 191 sides. The height of the CFA bifurcation level was classified into three groups: normal, high, and very high. Age, gender, left–right difference, height, weight, body mass index, and comorbidities, including hypertension, dyslipidemia, and diabetes, were examined to determine the factors associated with high CFA bifurcation level.


      The normal, high, and very high groups were on 142, 35, and 14 sides, respectively. The high and very high groups, which were defined as high CFA bifurcation levels, accounted for 25% of all patients. Multivariate analysis revealed that the proportion of patients with high CFA bifurcation levels was higher in the elderly (p = 0.009) and those with a history of diabetes (p = 0.042).


      Approximately one-fourth of all patients undergoing cerebral angiography or endovascular treatment by FA puncture had high CFA bifurcation levels, which had a significant association with old age and history of diabetes. For urgent treatment, FA puncture might be performed at a higher level below the inguinal ligament if patients are elderly of those with a history of diabetes.

      Key Words


      AVF (Arteriovenous fistula), AVM (Arteriovenous malformation), BMI (Body mass index), CFA (Common femoral artery), FA (Femoral artery)
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