Common femoral access (CFA) achieved with a novel technique using a micropuncture needle (MPN) resulted in fewer needle attempts and significantly fewer vascular complications, according to a new study. Massoud A. Leesar, MD, of the University of Alabama at Birmingham, reported these findings Saturday during a Featured Clinical Science presentation at Cardiovascular Research Technologies (CRT) 2023 in Washington, D.C. Anterior-posterior (AP) fluoroscopic projection is a standard technique for common femoral artery (CFA) access. Randomized trials have shown that the rates of CFA access and vascular bleeding complications were not significantly different between the AP technique and ultrasound guidance. Leesar and colleagues reported in a 2020 manuscript that a novel technique with a micropuncture needle (MPN) led to A high rate of CFA access. However, Leesar said Saturday, the procedural and clinical outcomes of the novel vs. AP technique with MPN have not been investigated. The current study randomized 200 patients to either the novel technique or the AP technique. The primary endpoint was the rate of successful access to the safe zone in the CFA. The intention-to-treat analysis included 99 patients in the novel arm and 96 in the AP arm. The novel technique had a significantly higher rate of needing only one needle puncture (83% vs. 63%, p<0.01) and a significantly lower rate of needing a second puncture (13% vs. 28%, p<0.01). Among all patients the rate of successful access to the CFA safe zone was significantly higher in the novel technique arm (94% vs. 81%, p<0.01). Success rates were consistently higher among all subgroups, including obese patients and those with peripheral vascular disease, but the difference was not statistically significant except in patients with high bifurcation (76% vs. 52%, p<0.01). The novel technique group also had a significantly lower rate of vascular complications (1% vs. 7%, p=0.008). However, Leesar said, the study was not powered for clinical outcomes, meaning a larger study is needed to compare the novel and AP techniques. Image Credit: Jason Wermers/CRTonline.org