Is the small size of the femoral artery

suggestive of chronic total occlusion of

the ipsilateral iliac artery ?
Thach Nguyen1, 2, Nguyen Khanh Duy3, Gianluca Rigateli4,
1. Methodist Hospitals, Merrillville, Indiana, USA 2. Tan Tao
University School of Medicine, Long An, VN 3. Vo Truong
Toan, School of Medicine, Can Tho, VN, 4. Rovigo General
Hospital, Rovigo, Italy,
VN Heart Association Scientific Meeting
Danang October 6th 2018
 BACKGROUND 1

When doing coronary angiogram by the femoral

approach, many times, the puncture of the femoral artery
was difficult because of weak femoral pulse.

What is the angiographic meaning of a weak femoral

pulse?
 BACKGROUND 2

Could it represent a chronic total occlusion of the

ipsilateral iliac artery?
 METHODS

Among the patients who underwent for coronary

angiogram by the femoral approach, the patients with
weak right femoral pulse were selected.

Patients with normal femoral pulse were also selected as

control.
Ultrasound of the Femoral Artery and Vein

All underwent
ultrasound of the
femoral artery and vein.
The size of the Femoral
Artery was to be
compared with the size
of the ipsilateral
Femoral Vein and of
the contralateral
Femoral Artery.
 Imaging 1

The image of the

Femoral Artery was
the coronal plane
proximal to the
bifurcation of the
superficial and deep
femoral artery.
 Imaging 2

In normal
condition, the
femoral artery
is a little
smaller than Femoral Artery
the femoral
vein.
Femoral Vein
 Imaging 3
If the Femoral Vein is
much smaller than the
Femoral Artery, the
patient has significant
contraction of the
intravascular Femoral Artery
compartment. It could be
Femoral Vein
due to blood loss if the
patient has bleeding.

Investigation of internal
and external bleeding
were conducted.
 RESULTS 1

10 patients with weak femoral pulse compared with

the left femoral artery were selected.

5 patients who had smaller Femoral Artery size

compared with the right Femoral Vein were also
selected as control
 RESULTS 2

Five patients
had much
smaller
Femoral Artery
Femoral Artery
compared with
the size of the Femoral Vein
Femoral vein.
 RESULTS 3

In these 5
patients with
smaller Femoral
Artery size, the
iliac angiogram
showed chronic
total occlusion of
the right iliac
artery
 RESULTS 4

the right iliac

angiogram
showed patent
iliac artery
 CONCLUSIONS

This is the first time, a much smaller size of the Femoral

Artery compared with the ipsilateral Femoral Vein and
contralateral Femoral Artery could represent the chronic
total occlusion of the ipsilateral iliac artery. Studies with
large number of patients are needed